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Surgical Treatment of the Neglected Achilles Tendon Rupture with Hyalonect

Cem Zeki Esenyel Department of Orthopaedic Surgery and Traumatology, Okmeydani Research and Training Hospital, Istanbul, Turkey.

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Cagri Tekin Department of Orthopaedic Surgery and Traumatology, Okmeydani Research and Training Hospital, Istanbul, Turkey.

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Murat Çakar Department of Orthopaedic Surgery and Traumatology, Okmeydani Research and Training Hospital, Istanbul, Turkey.

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Kursat Bayraktar Department of Orthopaedic Surgery and Traumatology, Okmeydani Research and Training Hospital, Istanbul, Turkey.

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Selcuk Saygili Department of Orthopaedic Surgery and Traumatology, Okmeydani Research and Training Hospital, Istanbul, Turkey.

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Meltem Esenyel Department of Physical Therapy and Rehabilitation, Medeniyet University, Göztepe Training and Research Hospital, İstanbul, Turkey.

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Zeynep N. Tekin Department of Radiology, Darica Farabi Government Hospital, Kocaeli, Turkey.

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Background

The purpose of this study was to report the management and outcomes of ten patients with chronic Achilles tendon rupture treated with a turndown gastrocnemius-soleus fascial flap wrapped with a surgical mesh (Hyalonect).

Methods

Ten men with neglected Achilles tendon rupture were treated with a centrally based turndown gastrocnemius fascial flap wrapped with Hyalonect. Hyalonect is a knitted mesh composed of HYAFF, a benzyl ester of hyaluronic acid. The Achilles tendon ruptures were diagnosed more than 1 month after injury. The mean patient age was 41 years. All of the patients had weakness of active plantarflexion. The mean preoperative American Orthopaedic Foot and Ankle Society score was 64.8.

Results

The functional outcome was excellent. The mean American Orthopaedic Foot and Ankle Society score was 97.8 at the latest follow-up. There were significant differences between the preoperative and postoperative scores. Ankle range of motion was similar in both ankles. Neither rerupture nor major complication, particularly of wound healing, was observed.

Conclusions

For patients with chronic Achilles tendon rupture with a rupture gap of at least 5 cm, surgical repair using a single turndown fascial flap covered with Hyalonect achieved excellent outcomes.

Corresponding author: Cem Zeki Esenyel, MD, Department of Orthopaedic Surgery and Traumatology, Okmeydani Research and Training Hospital, Darülaceze Cad. No:25 Okmeydan, Sisli, Istanbul, 34384 Turkey. (E-mail: esenyel@yahoo.com)