A Combined Repair Technique for Early Neglected Achilles Tendon Ruptures

This study presents the long-term results of a combined technique, using both Duthie's biological repair and a plantaris tendon transfer for the reconstruction of early neglected tendo Achilles ruptures.

Between January 2000 and November 2004, nine patients with an early neglected Achilles tendon rupture (≥ 4 and ≤ 12 weeks from injury), underwent surgical reconstruction. Eight patients were male and one female, their age was average 41 years and the median follow-up period was 3.66 years. The average clinical defect of the Achilles tendon was 4.33 cm.

All patients were examined by the clinical ankle scoring system of Leppilahti et al. (Clin Orthop 346:152-161, 1998). Six patients presented excellent results and three patients had good results. All patients had equal plantarflexion and dorsiflexion with the healthy side and all of the study's patients returned to work 3 months postoperatively. An average muscle atrophy of 0.83 cm was documented compared with the uninjured side. Only four of nine patients (44.44%) had a normal one-legged jump. There were no complications postoperatively and no re-ruptures of the Achilles tendons.

This combined method appears to be safe and effective, with a low risk for complications, allowing us to obtain excellent results for the majority of our patients.