Header

UZH-Logo

Maintenance Infos

Anterior Rectus Sheath Autograft in WRAP-Augmentation of Achilles Tendon Rupture


Schäfer, Frank P; Sander, Victor; Pothmann, Carina E M; Allemann, Florin; Simmen, Hans-Peter; Pape, Hans-Christoph (2019). Anterior Rectus Sheath Autograft in WRAP-Augmentation of Achilles Tendon Rupture. Journal of Foot and Ankle Surgery, 58(3):562-566.

Abstract

Achilles tendon ruptures can be counted as the most common traumatic ankle injuries. As such, there is a comparatively large set of treatment options including surgical and nonsurgical approaches. The purpose of this case report is to demonstrate a new technique for a specific subgroup of Achilles tendon ruptures that present with a large tendinous gap. We used a 2-step procedure designed to grant additional stability through an autograft from the anterior rectus sheath of the patient. Two patients were treated after suffering traumatic Achilles tendon ruptures on the left side with a gap of >3.5 cm and a high demand in daily activities. The reconstruction was performed using an upper quadrant recuts sheath as a WRAP-augmentation. After securing the transplant tissue, the abdominal wall was reconstructed using a Vicryl™-Prolene™ mesh (VYPRO, Johnson & Johnson Medical GmbH, Ethicon Deutschland, Norderstedt, Germany). After, a standard approach to the Achilles tendon was performed with a Kirchmayr-Kessler suture. The end result was then stabilized with a rectus sheath WRAP over a length of 14 to 15 cm. On the cases reported here, multiple clinical follow-ups were performed over a 5-year period. We can report highly satisfying results, with a return to sports activity after 6 months and no complications. As such we believe the rectus sheath autograft an effective solution for Achilles tendon ruptures with large gaps in healthy patients that demonstrate a high demand in daily activities.

Abstract

Achilles tendon ruptures can be counted as the most common traumatic ankle injuries. As such, there is a comparatively large set of treatment options including surgical and nonsurgical approaches. The purpose of this case report is to demonstrate a new technique for a specific subgroup of Achilles tendon ruptures that present with a large tendinous gap. We used a 2-step procedure designed to grant additional stability through an autograft from the anterior rectus sheath of the patient. Two patients were treated after suffering traumatic Achilles tendon ruptures on the left side with a gap of >3.5 cm and a high demand in daily activities. The reconstruction was performed using an upper quadrant recuts sheath as a WRAP-augmentation. After securing the transplant tissue, the abdominal wall was reconstructed using a Vicryl™-Prolene™ mesh (VYPRO, Johnson & Johnson Medical GmbH, Ethicon Deutschland, Norderstedt, Germany). After, a standard approach to the Achilles tendon was performed with a Kirchmayr-Kessler suture. The end result was then stabilized with a rectus sheath WRAP over a length of 14 to 15 cm. On the cases reported here, multiple clinical follow-ups were performed over a 5-year period. We can report highly satisfying results, with a return to sports activity after 6 months and no complications. As such we believe the rectus sheath autograft an effective solution for Achilles tendon ruptures with large gaps in healthy patients that demonstrate a high demand in daily activities.

Statistics

Citations

Altmetrics

Downloads

21 downloads since deposited on 14 Mar 2019
21 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 May 2019
Deposited On:14 Mar 2019 15:29
Last Modified:17 Sep 2019 20:06
Publisher:Elsevier
ISSN:1067-2516
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1053/j.jfas.2018.09.021
PubMed ID:30683517

Download

Download PDF  'Anterior Rectus Sheath Autograft in WRAP-Augmentation of Achilles Tendon Rupture'.
Preview
Content: Published Version
Filetype: PDF
Size: 1MB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)