Abstract
Fifty-four consecutive acute Achilles tendon ruptures were treated with end-to-end suture augmented with gastrocnemius fascial flaps. Surgery was performed within 24 h. Mean patient age was 35 (23–57) years, and 46 were men. Mean follow-up time was 4.8 (2–8) years. At follow-up, the mean visual analogue scale for pain was 0.49, and the mean AOFAS ankle–hindfoot score was 95 (74–100) points. Fifty-three patients were able to stand on their tiptoes for 30 s and perform repeated toe raises, and 50 patients were able to perform single-limb hopping. Complications included rerupture in one case, deep infection in three cases, delayed wound healing in eight cases, and deep venous thrombosis in one case. Reconstruction of acute ruptures of the Achilles tendon augmented with gastrocnemius-soleus fascial flaps provided a good outcome but was associated with a high complication rate.
Résumé
Cinquante-quatre ruptures récentes, consécutives, du tendon d’achille ont été traitées par suture bout à bout augmentée par un lambeau fascial du muscle jumeau. La chirurgie a été exécutée dans les vingt-quatre heures suivant la rupture. L’âge moyen des malades était de 35 ans (23–57) et 46 étaient de sexe masculin. Le temps de suivi moyen était de 4,8 ans (2–8). Au dernier examen la cotation visuelle moyenne pour la douleur était 0,49 et le score moyen de cheville AOFAS était de 95 points (74–100). Cinquante-trois malades étaient capables de se tenir sur la pointe des pieds trente secondes et d’exécuter des extensions d’orteils répétées, et 50 malades étaient capables d’exécuter un sautillement monopodal. Les complications ont été une rupture itérative dans un cas, une infection profonde dans trois cas, un retard de cicatrisation cutanée avec évolution favorable dans huit cas, et une thrombose veineuse profonde dans un cas. La reconstruction des ruptures récentes du tendon d’achille avec utilisation d’un lambeau du fascia des jumeaux a fourni un bon résultat mais avec un taux élevé de complications.
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