[Percutaneous achilles tendon lengthening through double hemisection in the treatment of achilles contracture syndrome].

ABSTRACT

OBJECTIVE: To explore the surgical approach of percutaneous double hemisection and evaluate its clinical efficacies. METHODS: From May 2006 to November 2011, a total of 59 patients were recruited. There were 36 males and 21 females with a mean age of 38.2 years (range 8 - 62). Forty-two varus and 6 valgus feet underwent percutaneous double hemisection. The 0.5 cm coracoid incision was adopted at the medial and lateral aspects of Achilles tendon. Percutaneous double hemisection was employed according to the deformity angles of varus and valgus feet. Manipulative correction was applied slowly until 30° dorsiflexion of ankle. Short leg cast was immobilized for 5 weeks at 30° dorsiflexion of ankle. The force of Achilles tendon, motion of ankle and Hannover Achilles tendon scores were followed up. RESULTS: Fifty-two patients were followed up for a mean period of 16.5 months (range 6 - 60). Seven patients were lost. At the end of follow-up, 48 patients with varus and valgus deformities were corrected effectively. When compared with the normal side, the force of Achilles of the operated side of 50 patients had no change while that of 2 patients decreased slightly; the motion of ankle joint increased from (2.8 ± 0.3)° preoperatively to (28.5 ± 1.4)° postoperatively (P < 0.05); the Hannover Achilles Tendon Scores rose from (68.5 ± 3.5) preoperatively to (82.6 ± 4.2) points postoperatively (P < 0.05). The outcomes were excellent (n = 44), very good (n = 5), good (n = 2) and poor (n = 1). The excellent and good rate was 94.2%. CONCLUSION: As an effective therapy for Achilles tendon contracture syndrome, percutaneous double hemisection has fewer complications and a faster recovery.