RESUMEN
Flexor hallucis longus transfer is routinely used as a technique to salvage a chronic or neglected Achilles tendon rupture. The single-incision (or short harvest) technique provides adequate graft suitable for fixation with interference screws. We have used a bore corer instead of a drill to establish the tendon tunnel and at the same time use the harvested autograft for interference fit and avoid the use of screws, providing what we consider to be a more biologic form of fixation.
Asunto(s)
Tendón Calcáneo/lesiones , Trasplante Óseo/métodos , Traumatismos de los Tendones/cirugía , Transferencia Tendinosa/métodos , Tendón Calcáneo/cirugía , Humanos , Rotura , Trasplante AutólogoRESUMEN
A case of a 22 year-old woman who sustained a closed Hawkins type II talar neck fracture after her left foot was caught in a rope while rock climbing outdoors is described. She presented to emergency department with a swollen and neurovascularly intact foot and a displaced talar neck fracture was identified. Intraoperatively a traumatic rupture of tibialis anterior tendon was found and was primarily repaired after the talar fixation. Revisiting the mechanism of injury it was evident that the jagged fracture ends ruptured the tibialis anterior tendon while she was hanging upside down on the strapping with the foot in forced equinus. This is the first case of such complication associated with a talar fracture and signifies the importance of tibialis anterior examination in such fractures.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Astrágalo/lesiones , Traumatismos de los Tendones/cirugía , Femenino , Fracturas Óseas/diagnóstico por imagen , Humanos , Rotura , Traumatismos de los Tendones/diagnóstico por imagen , Adulto JovenRESUMEN
PURPOSE: To describe a modified incision for the Brostrom procedure to correct lateral ankle instability. METHODS: 14 men and 12 women aged 23 to 38 (mean, 27) years with lateral ankle instability underwent the Brostrom procedure with a modified incision to repair both the anterior talofibular and calcaneofibular ligaments, without endangering the sural or superficial peroneal nerves. The incision ran longitudinally over the distal fibula extending 2.5 cm distal to the tip of the lateral malleolus. RESULTS: There were no instances of wound healing problems, neurological damage, and repair failure. Surgical exposure of all patients was graded as excellent. CONCLUSION: The modified incision enables easy repair without endangering the sural and superficial peroneal nerves. Access to the peroneal tendons is allowed if necessary.
Asunto(s)
Articulación del Tobillo/cirugía , Inestabilidad de la Articulación/cirugía , Ligamentos Articulares/cirugía , Procedimientos de Cirugía Plástica/métodos , Adulto , Articulación del Tobillo/fisiopatología , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
PURPOSE: To report the mid-term results of flexor hallucis longus (FHL) tendon transfer for reconstruction of chronically ruptured Achilles tendons. METHODS: 24 men and 12 women aged 56 to 78 (mean, 70) years underwent FHL tendon transfer for reconstruction of chronically ruptured Achilles tendons by a single surgeon. Ruptures were secondary to trauma (n=20), long-term steroid intake (n=12), or chronic renal failure (n=6). Two patients had bilateral ruptures. The mean interval from rupture to surgery was 15 (range, 12-24) weeks. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores were compared. Wound healing, push-off, and patient satisfaction were evaluated. RESULTS: The mean follow-up period was one year. The mean AOFAS scores were 69 (range, 58-76) preoperatively and 88 (range, 79-94) postoperatively; the mean improvement was 19 (p<0.001). 28 patients had excellent and 8 had fair results. 33 patients graded their outcome as 'very satisfactory' and 3 as 'satisfactory'. Five patients developed wound healing complications but only one needed debridement. There was no fixation-related complication or sural nerve injury. CONCLUSIONS: Transfer of the FHL for reconstruction of chronically ruptured Achilles tendons is effective, safe and easily performed in patients with low-to-moderate demands.
Asunto(s)
Tendón Calcáneo/lesiones , Tendón Calcáneo/cirugía , Traumatismos de los Tendones/cirugía , Transferencia Tendinosa/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Complicaciones Posoperatorias , Rango del Movimiento Articular , Rotura , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
The authors present a case of secondary chondrosarcomatous transformation in enchondroma in toe. The authors have discussed the available literature to throw light on differentiation of benign and malignant form.