Reconstruction of Chronic Achilles Tendon Rupture by V-Y Gastrocnemius Flap and Peroneus Brevis Transfer
Yousuf M Khira* and Mohammed A A Gheith
Faculty of Medicine, Zagazig University, Egypt
- *Corresponding Author:
- Yousuf M Khira
Assistant professor, Faculty of Medicine
Zagazig University, Egypt
E-mail: [email protected]
Received date: August 17, 2016; Accepted date: September 12, 2016; Published date: September 19, 2016
Citation: Khira YM, Gheith MAA (2016) Reconstruction of Chronic Achilles Tendon Rupture by V-Y Gastrocnemius Flap and Peroneus Brevis Transfer. Clin Res Foot Ankle 4:202. doi:10.4172/2329-910X.1000202
Copyright: © 2016 Khira YM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: Reporting the outcome of the modified peroneus brevis (PB) transfertechnique in treating 26 patients with chronic rupture of Achilles tendon (AT).
Methods: The diagnosis was neglected acute AT rupture in ten patients, ten with achronic rupture, re-rupture of the tendon in four cases, and Achilles xanthoma in two cases. The gap after debridement was 6 cm in average (range 4-8). The technique was V-Y gastrocnemius flaps of the ruptured AT in addition to peroneus brevis transfer. AOFAS score and isokinetic evaluation were used for functional assessment of ankle plantar flexion torque deficit in average 36 months follow up period (range 24-54 months).
Results: Significant improvement of the AOFAS score at latest follow up. No re-rupture nor major complication, particularly of wound healing, was observed, isokinetic testing at 30 degrees/second and 120 degrees/second revealed a significant average decrease of 28 ± 11% and 36 ± 4%, respectively, in plantar flexion peak torque. Although strength deficit persisted at latest follow up, functional improvement was significant without morbidity due to (PB) harvesting.
Conclusion: The surgical technique of V-Y myotendinous advancement of gastrosoleus tendon augmented by modified PB transfer for the treatment of chronic or neglected ruptures of AT with a gap of 6 cm length or more is a successful technique leading to high percentage of repair site healing and achieved excellent functional outcome.