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Case Reports
. 2018 Mar 2;12(1):54.
doi: 10.1186/s13256-018-1610-6.

Reconstruction of a chronically ruptured Achilles tendon using an internal brace: a case report

Shuichi Chida  1 , Hitoshi Suzuki  2 , Moto Kobayashi  2 , Tsutomu Sakuraba  2 , Hideji Kura  3 , Naohisa Miyakoshi  4 , Yoichi Shimada  4
Affiliations
Case Reports

Reconstruction of a chronically ruptured Achilles tendon using an internal brace: a case report

Shuichi Chida et al. J Med Case Rep. .

Abstract

Background: We reconstructed a chronically ruptured Achilles tendon and the associated scar tissue using braided polyblend polyethylene sutures (FiberWire; Arthrex Inc.; Naples, FL, USA) and anchors.

Case presentation: A 68-year-old Japanese man, who was being treated for right Achilles tendinosis, felt pain in his Achilles tendon when walking and started to find plantar flexion of his ankle joint difficult. As his symptoms persisted, he visited us after 4 weeks. Surgery and orthotic therapy were recommended, but he did not want to undergo these treatments. However, he began to find walking difficult and so underwent surgery 6 months after suffering the injury. The interior of the tendon was curetted, and the ruptured region was subjected to plication using the surrounding scar tissue. Using the percutaneous Achilles repair system (Arthrex Inc.), FiberWire sutures were inserted, and two skin incisions were made on the medial and lateral sides of his calcaneus in the region surrounding the Achilles tendon attachment. SutureLasso (Arthrex Inc.) was passed through, and the proximal FiberWire suture was relayed and fixed with 4.75-mm SwiveLock (Arthrex Inc.). After surgery, his foot was fixed in plaster at 20° plantar flexion of his ankle joint. The plaster was removed 1 week after surgery, and after-treatment was initiated with active dorsiflexion training. No orthosis was used after surgery. As of 16 postoperative months, no re-rupture had occurred.

Conclusions: This method might allow post-treatment rehabilitation, and so on, to occur earlier, and, hence, could become an option for the reconstruction of chronically ruptured Achilles tendons.

Keywords: Achilles Midsubstance SpeedBridge Repair; Chronic rupturing of Achilles tendon; Rehabilitation.

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Conflict of interest statement

Ethics approval and consent to participate

The patient described in this case report agreed that information will be used for publication.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Preoperative magnetic resonance imaging. Parts of the Achilles tendon remained intact, but the tendon was extended (arrow)
Fig. 2
Fig. 2
Intraoperative findings. a The ruptured region of the tendon had been cicatrized, and the interior of the tendon was hollow. b The ruptured region was subjected to plication using scar tissue. c Achilles Midsubstance SpeedBridge repair was performed concomitantly
Fig. 3
Fig. 3
Magnetic resonance imaging scan obtained at 6 postoperative months. Continuity of the Achilles tendon was observed
See this image and copyright information in PMC

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