Differential elongation of the gastrocnemius after Achilles tendon rupture: a novel technique of selective shortening to treat push-off weakness with case series and literature review
- 14.10.2023
- ANKLE
Erschienen in:
- Verfasst von
- Choon Chiet Hong
- Susanne Olesen Schaarup
- James Calder
- Erschienen in
- Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2023
Abstract
Purpose
Differential elongation of the gastrocnemius after Achilles tendon rupture (ATR) may compromise the ability of athletes to return to competition. Recognition of this differential elongation of the gastrocnemius relative to the soleus is vital to treat patients with weakness in push-off. This paper describes a novel technique performed for selective shortening of the gastrocnemius to treat push-off weakness.
Methods
Three patients with differential proximal retraction of the gastrocnemius greater than 20 mm after treatment for ATR with inability to run and jump underwent surgical correction with this novel technique and were followed-up for 2 years. A novel selective shortening of the gastrocnemius with autologous hamstring graft was performed in these patients. The Achilles Tendon Total Rupture Score (ATRS) and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score were recorded preoperatively and at the final follow-up.
Results
All three patients were able to return to running and jumping at final follow-up. The ATRS improved significantly in the strength, fatigue, running and jumping domains but there appeared to be a less notable improvement in activities of daily living domain. The AOFAS score showed improvement with the greatest margin in the domain of activity limitation.
Conclusion
This procedure is the first described selective shortening method of the gastrocnemius tendons after differential elongation following ATR. It is a safe and reliable technique providing improved ATRS and AOFAS scores in three patients who were all able to return to running and jumping sports at 2-year follow-up.
Level of evidence
IV.
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- Titel
- Differential elongation of the gastrocnemius after Achilles tendon rupture: a novel technique of selective shortening to treat push-off weakness with case series and literature review
- Verfasst von
-
Choon Chiet Hong
Susanne Olesen Schaarup
James Calder
- Publikationsdatum
- 14.10.2023
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2023
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347 - DOI
- https://doi.org/10.1007/s00167-023-07619-1
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