WU Caifeng 1,2 , DING Xiaoheng 1 , WANG Zhengdan 1 , REN Shengquan 1 , LIU Chunlei 1
  • 1. Department of Hand Surgery, No. 971 Naval Hospital of PLA, Qingdao Shandong, 266000, P.R.China;
  • 2. Department of Orthopedics, the Affiliated Hospital of Qingdao University, Qingdao Shandong, 266000, P.R.China;
DING Xiaoheng, Email: dxhqd@126.com
Achilles tendon rupture; surgical incision; Achilles tendon suture
10.7507/1002-1892.202102025
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To explore the effectiveness of posterior median longitudinal W-shaped incision combined with layer-by-layer combing suture in the treatment of acute closed Achilles tendon rupture.Methods The clinical data of 32 patients with acute closed Achilles tendon rupture who met the selection criteria between August 2015 and February 2019 were retrospectively analyzed. There were 25 males and 7 females, with an average age of 33 years (range, 21-48 years). All of them were closed rupture of Achilles tendon caused by sports injury. Physical examination on admission: the rupture space of Achilles tendon was palpable; Thompson sign was positive; the rupture of Achilles tendon was confirmed by MRI and ultrasonography before operation, the distance between the broken end and the insertion point of Achilles tendon was 2-8 cm, with an average of 3.5 cm. The average time from injury to operation was 2.7 days (range, 1-10 days). During the operation, the posterior median longitudinal W-shaped incision of Achilles tendon was used to expose the broken end of Achilles tendon, and the deep and shallow double Kessler end-to-end suture+layer-by-layer combing suture were used to suture the Achilles tendon, and the skin incision was sutured by “V-Y”advancement. The postoperative complications were observed; the healing of Achilles tendon was observed by ultrasonography; at last follow-up, Arner Lindholm criteria was used to evaluate ankle function.Results The 32 patients were followed up 8-24 months, with an average of 12 months. The incision healed by first intention, without the complications of skin necrosis, nonunion, delayed healing, and infection, scar hyperplasia or ulcer, and symptom of peroneal nerve injury. No Achilles tendon rupture and deep infection occurred during the follow-up period. The ultrasonography examination showed that the Achilles tendon was healing. At last follow-up, according to Amer Lindholm evaluation standard, the results of ankle function was excellent in 26 cases and good in 6 cases.Conclusion The treatment of acute closed Achilles tendon rupture with a posterior median longitudinal W-shaped incision combined with deep and shallow double Kessler end-to-end suture+layer-by-layer combing suture is effective, which can fully exposed the incision, the quality of Achilles tendon anastomosis is reliable, and it can effectively avoid wound complications and iatrogenic injury of gastrocnemius nerve.

Citation： WU Caifeng, DING Xiaoheng, WANG Zhengdan, REN Shengquan, LIU Chunlei. Application of posterior median longitudinal W-shaped incision combined with layer-by-layer combing suture in acute closed Achilles tendon rupture. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(8): 946-949. doi: 10.7507/1002-1892.202102025 Copy

Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved