Neglected ruptures of the Achilles tendon. Combined V-Y sliding flap with Bosworth middle tendon strip with plantaris tendon reinforcement

摘要

One of the most usefull techniques in treating old, chronic, neglected ruptures of the Achilles tendon is the Abraham-Pankovich V-Y sliding flap wich can be combined with plantaris tendon reinforcement. Unfortunately using this technique it is difficult to achieve approximation of the tendon ends if the gap is larger than 4-5cm. For larger gaps we have developed a new technique, combining the Abraham-Pankovich V-Y sliding flap with the tendon strip technique described by Bosworth that was reinforced with a plantaris tendon autograft. Using this technique we were able to repair defects of more than 8 cm( approx. 4 cm from the V-Y flap and approx 4 cm from the middle strip of the Achilles tendon. Plantaris tendon reinforcement provides extra strength.