COMBING THE ACHILLES TENDON
DEFINITION OF ACHILLES TENDON RUPTURE
Achilles tendon rupture is a common injury that occurs when there is a partial or complete tear of the Achilles tendon, the largest tendon in the human body. This tendon is found at the back of the ankle and connects the calf muscles (the triceps surae muscle) to the heel bone (the calcaneus). It plays a crucial role in the ability to walk, run and jump.
Rupture of the Achilles tendon usually occurs when it is subjected to sudden and excessive stress, such as a sudden upward flexion movement of the foot (dorsiflexion) or direct impact to the area. Athletes playing sports that require sudden, explosive movements, such as basketball, tennis, or soccer, are particularly prone to this injury. However, it can also occur in less active people due to weakening of the tendon with age or other predisposing factors.
Symptoms of a ruptured Achilles tendon may include sharp pain in the back of the ankle or calf, a popping or tearing sound at the time of injury, difficulty walking or climbing stairs, and swelling and tenderness in the affected area.
Treatment for a ruptured Achilles tendon depends on the severity of the injury. In cases of partial or mild rupture, conservative treatment, such as rest, immobilization in a walking boot, physical therapy, and strengthening exercises, may be recommended. For complete or severe ruptures, surgery to repair the tendon may be necessary, followed by intensive rehabilitation.
An untreated or poorly managed Achilles tendon rupture can lead to long-term complications, such as decreased ankle strength and function, as well as an increased risk of injury recurrence. It is therefore important to consult a healthcare professional as soon as possible if you suspect an Achilles tendon rupture to get an accurate diagnosis and appropriate treatment plan.
WHY OPERATE TO RUPTURE THE ACHILLES TENDON?
Surgery to repair a ruptured Achilles tendon is often recommended in cases where the rupture is complete or severe, or when conservative treatment has not produced the desired results. Here are some reasons why surgery may be necessary :
- Restore normal tendon anatomy : The main goal of surgery is to restore continuity to the Achilles tendon by suturing the torn ends. This helps restore the strength and function of the tendon, as well as minimizing the risk of recurrence of the injury.
- Strengthen ankle stability : Surgical repair of the Achilles tendon helps restore ankle stability, which is crucial for daily activities as well as for resuming sports or physical activities.
- Accelerate the healing process : In many cases, surgery provides faster and more predictable healing of the Achilles tendon compared to conservative treatment alone. This can reduce the overall recovery period and allow patients to return to normal activities more quickly.
- Reduce the risk of long-term complications : Proper surgical repair can help minimize the risk of long-term complications, such as ankle stiffness, persistent muscle weakness, and increased risk of injury recurrence.
- Improve long-term functional outcomes : For active or athletic individuals, surgical repair of the Achilles tendon may provide better long-term functional outcomes, allowing them to return to a high level of athletic performance and reduce the risk of recurring injuries.
It is important to note that the decision to opt for surgery for a ruptured Achilles tendon will depend on several factors, including the severity of the injury, the patient’s lifestyle, functional goals, and medical condition. general. It is recommended to discuss with a healthcare professional to determine the best treatment plan for each specific case.
DEFINITION OF ACHILLES TENDON COMBING
Achilles tendon combing is a surgical procedure that aims to treat Achilles tendon conditions, such as Achilles tendinopathy or partial tendon rupture, by removing damaged or degenerated tissue from the tendon.
When combing the Achilles tendon, the surgeon makes small incisions in the affected tendon. Then, using a specialized instrument called a “comb,” the surgeon gently removes any degenerated soft tissue or adhesions that may have formed on the surface of the tendon. This technique eliminates areas of tendon dysfunction and stimulates healing and regeneration of healthy tissues.
Achilles tendon combing can be used as a treatment for Achilles tendon conditions that do not respond to conservative treatments such as physical therapy, orthotics, anti-inflammatory medications, or corticosteroid injections. It may also be used as an adjunct to other surgical procedures, such as partial Achilles tendon rupture repair.
This technique is generally considered less invasive than other more extensive surgical procedures, such as repairing the complete rupture of the Achilles tendon. However, as with any surgical procedure, there are potential risks associated with Achilles tendon combing, including the risks of infection, bleeding, persistent pain, or recurrence of the condition.
Before undergoing an Achilles tendon combing procedure, it is important to speak with a healthcare professional to understand the benefits, risks, and available alternatives, as well as to determine if this surgical procedure is the best option to treat your specific Achilles tendon condition.
POST-OPERATIVE REHABILITATION AND RESUMPTION TO ACTIVITIES
Following combing of the Achilles tendon, the patient is placed in a cast for approximately six weeks, during which the patient cannot support himself on his foot.
The plaster will promote protection of the operated area and healing. Since the patient will remain immobile, anticoagulants are prescribed to limit the risk of phlebitis.
Rehabilitation can begin with a physiotherapist as soon as the cast is removed. The patient can then hope to drive again approximately 8 days after the removal of the cast, and regarding the resumption of his professional activity, it depends on the arduousness of this.
An administrative profession, for example, can be resumed after 45 days, while a more physical profession can be resumed after 3 months.
In the same way, the resumption of sporting activity will be done smoothly and from the 4th month after the operation. A sport in which the patient must jump or dash, such as running or athletics, can only be resumed from the 6th month after the operation. Combing the Achilles tendon requires significant healing time and good convalescence will increase the effectiveness of the surgery if it is respected.
RISKS AND COMPLICATIONS OF ACHILLES TENDON COMBING
Like any surgical operation, Achilles tendon combing can present complications.
However, in the context of this surgery, complications are rather rare. Among these complications, hematoma is usually treated with medication and deep infection is very exceptional but may require new intervention and prolonged treatment with antibiotics.
Likewise, the patient may suffer from algodystrophy, which is an inflammatory and rather painful complication.
It can occur at any time and last several months. Also, the patient may feel discomfort when putting on shoes and pain which is due to persistent inflammation.
Among the complications of the operation, specialists also report scar adhesions which require a few physiotherapy sessions. It is important to keep in mind that complications are not the same from patient to patient and also depend on the patient’s health condition.
EXPECTED RESULTS OF ACHILLES TENDON COMBING
Achilles tendon surgery promises recovery of motor functions and a disappearance of pain linked to tendon rupture.
It is an intervention that is appreciated because of the stimulation it provides for healing.
If the healing is good, walking can be done without pain in the six months following the operation. The final result can generally be measured 6 months post-operatively.
Achilles tendon combing shows very good results for most operated patients, around 90% satisfaction.
