Repair of acute Achilles tears with plantaris augmentation

• Published in: International orthopaedics Vol. 45; no. 9; pp. 2285 - 2290
• Main Authors: Prejbeanu, Radu, Vermesan, Dinu, Balanescu, Andrei, Mioc, Mihail Lazar, Haragus, Horia
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2021
• Subjects: Medicine; Medicine & Public Health; Original Paper; Orthopedics; Achilles tendon injuries; Tendon surgery; Foot surgery; Plantaris tendon; Suture techniques; Achilles tendon surgery
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-021-05169-0

Purpose
To determine the benefits associated with using the fanned out plantaris tendon as a membrane to cover and augment the acute Achilles tendon midportion end-to-end suture repair.
Methods
Between 2014 and 2018, 31 (67.4%) patients had plantaris augmented reconstruction and 15 simple end-to-end suture. The clinician filled out the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and the patient the Achilles tendon total rupture score (ATRS). Examination included clinical examination, limb symmetry index (LSI) using the heel rise test, and ultrasound determination of cross-sectional area (CSA).
Results
80.4% were males, mean age 41 (SD 6.7, range 29–57), of which 82.6% were sports accidents. 39/46 were operated in less than two weeks from injury. 82.6% were available at the two year follow-up. Duration of surgery (62.3 min vs 58,
p
 = 0.45), AOFAS (89.6 vs 88.4,
p
 = 0.61 and 97.2 vs 96.8,
p
 = 0.72), ATRS (86.3 vs 83.8,
p
 = 0.33 and 95.6 vs 93.6,
p
 = 0.12), LSI (60.8% vs 58.75,
p
 = 0.24 and 80.5 vs 79,
p
 = 0.29), CSA (3.39cm
2
vs 3.36,
p
 = 0.82 and 2.57 vs 2.59,
p
 = 0.87), return to sport (80% vs 57,
p
 = 0.15 and 84.6 vs 85.7,
p
 = 1.00), and complications at six months and two years were comparable between the two techniques.
Conclusion
Fanned out plantaris augmentation of acute Achilles tendon tears yields excellent and comparable clinical and ultrasonographic results to end-to-end suture at mid-term follow-up