Achilles tendon extension

Achilles tendon extension is a commonly used and effective soft tissue procedure for correcting deformity of the ankle. Congenital palpebral varus is simple in the early stage of flexion, and can be corrected by achilles tendon extension alone. The varus varus should be treated as a aponeurosis. In children, Achilles tendon extension or other soft tissue surgery can be used to correct the plantar flexion deformity, and then the stent can be used to maintain the correction position to prevent malformation and improve function, which will create favorable conditions for future bone surgery.

Treatment of diseases: congenital tibia adductor malformation congenital clubfoot

Indication

1. Congenital palpebral varus is simple in the early stage of flexion, and can be corrected by achilles tendon extension alone. The varus varus should be treated as a aponeurosis. Orthopedic surgery is required for bone deformity.

2. Paralytic plantar flexion deformity includes foot flexion, flexion and inversion, and flexion and valgus. In children, Achilles tendon extension or other soft tissue surgery can be used to correct the plantar flexion deformity, and then the stent can be used to maintain the correction position to prevent malformation and improve function, which will create favorable conditions for future bone surgery.

3. The foot and joints of the foot have obvious deformation of the plantar flexion. If the age is over 12 years old, bone surgery (such as three-joint fusion or ankle joint fusion) is needed to correct the deformity; Those who have contractures should first make achilles tendon extension, which can not only reduce bone resection, but also receive satisfactory results.

Achilles tendon severance is a surgical procedure used to treat Achilles tendinopathy. Surgical treatment is required for non-surgical treatment failure, 6 months or more after birth, or older untreated.

Contraindications

1. Patients with bleeding-prone diseases should wait for the coagulation function to return to normal before performing surgery;

2, allergic to local anesthetics, or anti-anaesthetic should pay attention.

Preoperative preparation

1. Pre-operative regular skin preparation for 3 days.

2. For those with skin palsy, it should be softened and cleaned with warm water 1 week before surgery to facilitate surgery.

3. Preoperative examination of the deformity of the foot and its causes (such as muscle contracture or paralysis, soft tissue contracture, etc.), and then design surgery according to the situation, in order to obtain satisfactory results.

Surgical procedure

Choose position

Select the side prone position.

Make an incision

A 0.5 cm longitudinal incision was made at the outer edge of the achilles tendon at 1 cm, and a second 0.5 cm incision was made at the inner edge of the Achilles tendon at a distance of 4 to 6 cm depending on the degree of plantar flexion.

Cut off the Achilles tendon

Back flexion of the ankle joint makes the Achilles tendon. Use a sharp-edged knife tip to extend subcutaneously from the incision and slide against the lateral edge of the Achilles tendon to the front edge, half the width of the Achilles tendon. There are posterior iliac vessels and nerves in front of the medial aspect of the Achilles tendon. Then pick the knife backwards to cut off the upper and lower half of the Achilles tendon. Be careful not to use excessive force to cut the skin. The medial malleolus should be cut off together.

Extend the Achilles tendon

Strong dorsiflexion of the ankle joint, tearing the Achilles tendon can be extended up and down, at least 10 degrees of dorsiflexion. The dorsiflexion should be carried out slowly to avoid tearing the skin.

Stitching

There is very little bleeding, no need to stop bleeding, suture the skin.

External fixation

The knee was fixed in the semi-flexion position with a plaster support, and the dorsiflexion was 10°.

complication

Infection: If you do not pay attention to hygiene or anti-infection, it is easy to cause wound infection. If it happens, you should seek medical advice immediately.