Abstract

Background: This study aimed to evaluate the long-term follow-up results of V-Y tendon plasty with fascia turndown, for repairing chronic Achilles tendon ruptures.

Methods: Seventeen patients (12 males, 5 females), who were diagnosed with chronic Achilles tendon rupture and met the inclusion criteria, were included in the study. These patients received treatment by means of V-Y tendon plasty with fascia turndown from January 1995 to December 2001. Clinical outcomes of the patients were assessed by using isokinetic strength testing, questioning the patient regarding residual discomfort, pain, or swelling and having the ability to perform heel rises and using American Orthopaedic Foot & Ankle Society's (AOFAS's) Ankle-Hind Foot Scale score. Mean follow-up duration was 16 years (13-18 years).

Results: Mean time from the injury to operative treatment was 7 months. Mean operative defect of Achilles tendon in neutral position after debridement was 6 cm. During the follow-up, the mean calf atrophy was 3.4 cm. The mean 30 degrees/s plantarflex and 120 degrees/s plantarflex peak torques were 89 and 45 Nm, respectively. The mean 30 degrees/s plantarflex peak torque deficiency was 16%. The mean 120 degrees/s plantarflex peak torque deficiency was 17%. The average peak torque deficiency was 17%. The pre- and postoperative mean AOFAS Ankle-Hindfoot Scale scores were 64 and 95, respectively. No patient had a rerupture. Superficial wound infection was treated with oral antibiotic therapy in 2 patients (11%).

Conclusions: The V-Y tendon plasty with fascia turndown for repairing chronic Achilles tendon ruptures yielded results comparable with the literature regarding clinical outcomes. This method did not require synthetic materials for augmentation and was an economic alternative compared to other repair methods.

Level of evidence: Level III, retrospective comparative study.

Keywords: Achilles tendon reconstruction; chronic Achilles tendon tear; neglected rupture.