[A new method of surgical treatment of patients with chronic distal Achilles tendon rupture]. / Novyi sposob khirurgicheskogo lecheniya patsientov s distal'nym razryvom akhillova sukhozhiliya.

OBJECTIVE: To improve postoperative outcomes in patients with distal Achilles tendon rupture by using of a new method of surgical treatment. MATERIAL AND METHODS: The authors proposed a new method to restore the Achilles tendon for its distal rupture (within 2 cm from attachment to the calcaneus). This approach implies forming a canal in the calcaneus and minimally invasive harvesting of the plantar tendon. At the next stage, the plantar tendon is passed through the canal of the calcaneus in U-shaped fashion and proximal part of Achilles tendon with maximum approximation of its fragments and imposing of interrupted sutures on the plantar and Achilles tendons to hold the position. The end of plantar tendon is used to reinforce damaged area. The schemes and surgical stages are shown in the figures. We reported a patient with distal Achilles tendon rupture and postoperative outcome. RESULTS: An above-mentioned approach was applied in 26 patients. The control group consisted of 21 patients who underwent recovery with anchor fixers. Early and long-term postoperative results, as well as adverse events were analyzed in both groups. Biomechanical parameters of gait were evaluated from the standpoint of evidence-based medicine using podography and functional myography. We confirmed an advantage of treatment in the main group.

[New surgical method for chronic rupture of the Achilles tendon]. / Khirurgicheskoe lechenie patsientov s zastarelym razryvom akhillova sukhozhiliia.

AIM: To improve the outcomes in patients with chronic ruptures of the Achilles tendon followed by advanced diastase and reduced function of the gastrocnemius muscle by using of new surgical method. MATERIAL AND METHODS: The authors proposed a new method of Achilles tendon repair for diastase over 10 cm. It imposes transposition of the tendons of short fibular muscle and posterior tibial muscle. Schemes and stages of surgery are presented in figures. The authors described clinical example of patient with chronic rupture of the Achilles tendon, illustrations of surgical stages and the outcome. RESULTS: New surgical approach was applied in 16 patients. The control group consisted of 21 patients who underwent repair by Chernavsky, Krasnov. Clinical and biomechanical methods were used for evaluation. Functional myography and podography to assess the asymmetry of gait were performed. Our data confirmed the advantage of new approach.