Abstract
Introduction:
The most prevalent tendon rupture in the lower extremities is an achilles tendon rupture. Adults in their third to fifth decades of life are the ones who sustain the injury most frequently. The optimal method for treating these ruptures is not generally agreed upon in the literature. The objective of this study was to evaluate the functional outcomes of the gastrosoleus turn down flap method used to repair the neglected achilles tendon rupture.
Methods:
A 58-year-old woman who has had difficulty in walking for 6 months after slipping on the floor. The modified Lindholm method, with a turn-down of the gastrosoleus flap, was used to repair the neglected achilles tendon rupture. The patient was positioned prone, and a posterior incision was used to access the ruptured tendon. There was a complete rupture of the achilles tendon along with some fibrous tissue. The torn ends were cut into fresh tissue, and the scar tissue that had formed between the torn proximal and distal ends was resected. The gap was 10 cm. The repair was then reinforced using a 12-cm-long and 2-cm-wide segment of gastrosoleus fascia that was trimmed sharply by horizontal incision and divided into two layers, and it was then rotated 180 degrees upside down. The flap was then pulled gently but steadily in the distal direction until it bridged the gap and connected with the distal tendon. The Krackow technique was then used to suture the flap to the end of the distal stump. The tension was roughly adjusted so that the foot would be in an equinus posture with normal gravity.
Results:
At 6 weeks after the operation, the patient is able to walk and perform regular daily activities. No recurrent rupture and further complications were reported.
Conclusion:
According to this study, the gastrosoleus turn down flap method for neglected achilles tendon rupture repair provides a functional outcome that is satisfactory.