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Achillies tear

Posted by William Maguire on 9/03/03 at 13:45 (128700)

I have just been informed that th tendon going uop the back of my leg (the achillies?) has torn away from the heel bone and I will require surgery.
How successful has this type of surgery been or is it a case where reattachment cannot be made?

Re: Achillies tear

Ed Davis,DPM on 9/03/03 at 15:22 (128706)

Reattachment can always be made. How did the tear happen?
This is a very important question because a tear due to significant trauma usually involves a tear of healthy tissue so there is good tissue to attach, provided it is not shredded. A tear that occurred with only moderate trauma implies that diseased tissue occurred at the attachment.
In the latter case or if significant shredding of healthy tissue occurred, the diseased tissue must be trimmed back before re-attachment.

If a significant amount of tissue is trimmed back, the tendon is shorter.
If such shortening is significant the aponeurosis of the gastroc. needs to be lengthened in order to maintain a normal length tension relationship and avoid futher surgery. Sorry that I cannot make this answer simpler but there is a lot to consider here.
Ed

Re: Achillies tear

Dr. Z on 9/03/03 at 17:05 (128713)

This is very sucessful so long as your surgeon as the ability to either repair and or use a graft

Re: Achillies tear

William Maguire on 9/03/03 at 21:44 (128737)

I had heel pain for over a year and finally my physician a GP, had my foot x-rayed and found that I had three spurs, he then sent me to a orthapaedist who gave me a cortisone shot on 22Jul. the pain left and I was walking and golfing normally when after three weeks the pain came back. I tried for an appointment with the orthopeadist on the 22nd of Aug. and received an appointment for the 12th of Sep.
On Sat. Aug 23rd a felt a sharp pain and heard a snap (my wife while walking with me also heard it).I then contacted my GP on the 26th and was not able to get an appointment with him until 1st of Sep. when he diagnosed it as a torn acchilies from the heel bone. He is now seeking an appointment for me with an othopaedic surgeon.

Re: Achillies tear

Pauline on 9/04/03 at 07:49 (128750)

I've never experienced a torn achillies tendon which must be quite painful. Could you have received faster treatment by going through the E.R.? They would be in a good position to contact an ortho for you.

Hopfully the route you've taken will produce some pain relief for you soon, but the waiting must be difficult.

Re: Achillies tear

Ed Davis,DPM on 9/04/03 at 16:40 (128779)

I hope that the cortisone shot was not in the achilles tendon. There have been reports of achilles tendon rupture with as little as one shot in the tendon.
Ed

Re: Achillies tear

Ed Davis,DPM on 9/04/03 at 16:43 (128780)

PS. If the shot was in the achilles or back of the heel, it may have been the cause of the rupture. I certainly would not return to the individual that may have caused the rupture.
Ed

Re: Achillies tear PPS

Ed Davis,DPM on 9/04/03 at 16:52 (128781)

PPS
If an achilles rupture occurs due to a cortisone shot, one must assume that the tissue at the area of rupture is of insufficient quality/strength for a good re-attachment so the poor tissue must be trimmed back to a level of good healthy tissue for a successful re-attachment. As mentioned previously, if that leaves the tendon short, it is often necessary to gain additional length via a graft or by lengthening of the gastrocnemius aponeurosis (my preference). The gastroc. aponeurosis is the tissue in between the calf muscle and the tendon.
Ed

Re: Achillies tear PPS

William Maguire on 9/05/03 at 06:07 (128834)

Thaank you at least it seems that there is hope of reconstruction

Re: Achillies tear PPS

Ed Davis,DPM on 9/05/03 at 11:50 (128862)

William:
Where was the shot given? If it was at the point of rupture, that is an important consideration.
Ed