Operative shortening of the elongated defunctioned tendoachillies following previous rupture

Healing of the tendoachilles (TA) following rupture may result in lengthening over a long segment rather than discrete scar interposition. We describe our experience and results of a direct TA shortening technique of dysfunctionally long TAs. Five patients presented with impairment of their sporting level. Four patients had TA injuries that were managed by physiotherapy alone and 1 had been cast immobilised for 6 weeks. At open operation the TAs were found to be confluent but with evidence of scarring over a long segment. A 'Z' shortening was performed. The patients were reviewed up to a mean of 30 months post op. The overall scores were excellent in 1, good in 3 and fair in 1. All returned to their chosen level of sporting activity. The technique described is relatively straightforward and gives predictable improvement in function. It is therefore a useful technique in this often-unrecognised condition