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Achilles tendon and problems related to rupture of Achilles tendon

Source:Aineng biotech Time:2016-08-11 09:17:57

What is Achilles tendon? What are the functions of Achilles tendon? What kinds of rupture of Achilles tendon How to judge it is rupture or avulsion of Achilles tendon? If the suspicion is rupture of Achilles tendon, what examination(s) shall I do? How to do Thompsons test? My Achilles tendon is ruptured, what methods could be employed for treatment?

1、Question: What is Achilles tendon? What are the functions of Achilles tendon?

Answer: Achilles tendon is a strong, thick and firm tendon located between heel and the calf. Achilles is about 15cm, the thickest tendon in human body, which is formed from triceps surae. People walking, running and jumping depend on the strong tendon. If the tendon is completely broken, it will be difficult to move an inch.

2、Question: What kinds of rupture of Achilles tendon have?

Answer: Achilles tendon rupture can be divided into two categories: One is spontaneous broken; one is the fracture caused by trauma.

3、Question: How to judge it is rupture or avulsion of Achilles tendon? If the suspicion is rupture of Achilles tendon, what examination(s) shall I do?

Answer: Magnetic resonance imaging (MRI) is the best, and then ultrasonography can be considered with hand diagnosis. (1) Medical history: Most of patients with acute Achilles tendon rupture have a clear history of motor injuries, and the rear ankle of most injured has a direct sense or hears "bang", and damage usually occurs during a sudden outbreak of bouncing action. (2)Symptoms and signs: The patients can not pull toes, and there are recesses and accompanied by swelling or bruise behind the Achilles. Defect can be palpable in local physical examination and Thompson is positive. (3).Imaging examination: Achilles tendon rupture can be found in the magnetic resonance imaging which is the most effective for the confirmation of partial rupture of the Achilles tendon; Ultrasound technique can be used to evaluate the distance between the two ends of the tendons; Ordinary X-ray can be used to determine whether or not there is acute fracture avulsion on the attachment part of Achilles tendon accompanied.

4、Question: How to do Thompsons test?

Answer: Thompsons test can clearly show whether there are ruptures on the foot Achilles tendon. Make the patient prone with feet hanging in the edge of the bed check. To squeeze gastrocnemius, and if plantar flexion of the foot does not appear, that indicates Achilles tendon rupture.

5、Question: My Achilles tendon is ruptured, what methods could be employed for treatment?

Answer: There are two common treatments for Achilles tendon rupture:

Non-surgical treatment (conservative) and surgical treatment. Non-surgical treatment, to be fixed by plaster or Achilles tendon boot, prompting the two ends close to each other to promote healing of Achilles tendon stump. Disadvantages: ★Tendon re-rupture rate of Achilles: 1.7%-30%.

Surgical treatment is divided into open surgery, percutaneous repair, arthroscopic repair surgery, minimally invasive surgery for Achilles tendon rupture channel (using the Micro with Links) and so on.

6、Question: How is the effect of each surgery treatment?

Answer: Open surgery Namely the traditional suture, which is domestic traditional surgical approach, but there are a large incision, long operation time, great surgical injury, etc., easily leading to infection, skin necrosis, Achilles tendon exposure, Achilles tendon adhesions, Achilles tendon re-rupture, which may need the second skin graft, flap surgery, a secondary Achilles tendon reconstruction surgery, etc.. There are complications in such current surgical approaches with the high incidence, which is a headache for doctors.

Percutaneous repair: Make no increase to risk of re-rupture of Achilles tendon, and decrease the risk of wound infection obviously. However, a higher proportion of common peroneal nerve injury exists in the surgical procedures. After nerve injury, patients’ innervations zone shows a loss of function with slow recovery, and even cannot be restored.

Arthroscopic repair: Arthroscopic repair of technical operations call for high technical requirements for the surgery operator and also the hospital with high arthroscopic equipment. And general hospitals are unable to carry out that, and the key hospitals cannot arrange the hospital inpatient.

Minimally invasive surgery for Achilles tendon rupture channel: Make no increase to risk of re-rupture of Achilles tendon, and decrease the risk of wound infection obviously. Through the establishment of suture channel, to use special channel suturing system, avoiding iatrogenic sural nerve injury and simplifying the surgical procedure with the incision length of only 1.5cm; which greatly shortens the operation time, and needs only 15-20 minutes

Comparison table:

The surgical comparison of common Achilles tendon rupture suture

Comparison items

Traditional suture

Minimally invasive Achilles tendon rupture channel stapler device

Similar foreign products

Percutaneous minimally invasive surgery

Arthroscope

The difficulty of operation

Medium

Small

Medium

Large

Maximum

Operation time

1-2h

10-30min

40min-1h

40min-1h

1-1.5h

Surgery opening

10-20cm

1.5-2cm

2-3cm

1-3cm

1cm

Surgical injury

The soft tissue injury is large and does great damage to the blood supply of the Achilles tendon

Small

Easy to hurt sural nerve

Easy to hurt sural nerve

Relatively small

Postoperative hospital days

≥1 week

1-2 days

1-3 days

1-3 days

1-2 days

The degree of recovery of motor function after surgery

Poor, be easy to adhesion

Honors

Good

Better

General

Complications

Secondary fracture, incision complications: Infection, skin necrosis, Achilles tendon exposure, etc.

Seldom

Easy to cause sural nerve damage

Easy to cause sural nerve damage

Easy to avulse, causing secondary fracture

Technical support

None

Beijing 301 Hospital

None

None

None

7、Question: Which hospital opens the minimally invasive surgery of the Achilles tendon rupture channel?

Answer: You can visit the cooperation projects of this site to find hospital, and due to update problems, if you cannot find, please give us a message, and we will send the latest hospital information. Also we can assist in contacting the hospital.

8、Question: Achilles tendon rupture after what stages can return to a normal life?

Answer: Patients with Achilles tendon rupture can generally go through a process like this: That operation seam, long plaster or brace around fixed for about four weeks, continue to fix with plaster or brace for about six weeks; Demolition of plaster or brace; Significant recovery period (about six weeks and feeling better and better every day); "Platform" rehabilitation period (about eight weeks, and feeling better very slowly); Consolidate rehabilitation (walking normal, bearing exercise is relatively safe; After 6 months of the surgery, depending on the recovery, you can participate in athletic competition).

9、Question: How to prevent Achilles tendon rupture?

Answer: Combined with epidemiological characteristics of acute Achilles tendon rupture, it can be recognized that super-strength and overload exercise is an important factor leading to Achilles tendon rupture. Therefore, especially for people for long-term static life or background work, gradually increase the amount of daily activities, and disperse the concentrated exercise time on weekend into the week and do the warm-up before exercise activities. Combined with their specific circumstances during exercise, select appropriate exercise, reduce excessive exercise time, etc., which will have a greater significance for the prevention of Achilles tendon rupture. Also to minimize the use of quinolones (gatifloxacin) drugs.

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