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Percutaneous Achilles tendon lengthening complicated by inadvertent tenotomy
1Department of Orthopaedics, U.S.C. School of Medicine, Columbia, South Carolina 29203.
Insights
Inadvertent Achilles tenotomy occurred in 13% of Hoke percutaneous triple hemisection Achilles tendon lengthening procedures. Patients with this complication showed similar outcomes to those without, suggesting good recovery potential.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Musculoskeletal Research
Background:
- Percutaneous triple hemisection is a surgical technique for Achilles tendon lengthening.
- Potential complications, such as inadvertent Achilles tenotomy, can occur during the procedure.
Purpose of the Study:
- To determine the incidence of inadvertent Achilles tenotomy during Hoke percutaneous triple hemisection.
- To compare the functional outcomes of patients who experienced inadvertent tenotomy versus those who did not.
Main Methods:
- Retrospective review of 37 Hoke percutaneous triple hemisection Achilles tendon lengthening procedures.
- Analysis of complication rates, specifically inadvertent Achilles tenotomy.
- Comparison of postoperative outcomes at 2 months using short leg walking cast immobilization.
Main Results:
- A 13% (five of 37) incidence of inadvertent Achilles tenotomy was observed.
- Three patients with bilateral procedures served as internal controls.
- Outcomes were indistinguishable between patients with and without inadvertent tenotomy after 2 months.
Conclusions:
- Inadvertent Achilles tenotomy is a complication associated with Hoke percutaneous triple hemisection.
- Despite the complication, functional recovery appears comparable to procedures without tenotomy.
- Further investigation may be warranted to optimize surgical technique and minimize this complication.
Abstract:
Thirteen percent (five of 37) of all Hoke percutaneous triple hemisection Achilles tendon lengthenings performed at a teaching hospital in a 4-year period were complicated by inadvertent Achilles tenotomy. Three of the five patients had bilateral procedures and served as their own controls. After 2 months of postoperative short leg walking cast immobilization, the results in patients with inadvertent Achilles tenotomy were indistinguishable from those in whom tendon continuity was maintained.