Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures

<b>Background/Objectives:</b> Acute ruptures of the Achilles Tendon (AT) are common injuries in the active population, in particular among men aged 30 to 50. Full functional recovery after this kind of injury is long and challenging and nowadays there is no universal “gold standard” stra...

Full description

Saved in:
Bibliographic Details
Main Authors: Alessandro Pisano, Gaetano Caruso
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Surgical Techniques Development
Subjects:
Online Access:https://www.mdpi.com/2038-9582/13/4/30
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850060001857503232
author Alessandro Pisano
Gaetano Caruso
author_facet Alessandro Pisano
Gaetano Caruso
author_sort Alessandro Pisano
collection DOAJ
description <b>Background/Objectives:</b> Acute ruptures of the Achilles Tendon (AT) are common injuries in the active population, in particular among men aged 30 to 50. Full functional recovery after this kind of injury is long and challenging and nowadays there is no universal “gold standard” strategy when dealing with them. <b>Methods:</b> When it comes to surgical treatment, various techniques have been described: in case of a typical lesion at the midportion of the tendon (which is the most common type), the basic principle of surgical repair is the end-to-end suture of the tendon stumps. The AT (“calcaneal tendon” according to the <i>International Anatomical Terminology</i>) is the strongest tendon of the human body, it is the conjunct tendon of the two Gastrocnemii Muscles and the Soleus Muscle and has a <b>well-recognizable twisted structure</b>: the subtendon from the Medial Head of the Gastrocnemius attaches postero-laterally on the calcaneal tendon footprint, the subtendon from the Lateral Head of the Gastrocnemius attaches antero-laterally and the subtendon from the Soleus attaches medially, therefore creating a 90° twist of the tendon structure. <b>Results: the twisted structure of the human AT is of central importance to its biomechanics</b>, since it gives the tendon a higher resistance to deformation and concurs in supination of the subtalar joint during gait. <b>Conclusions:</b> given the abovementioned anatomical and biomechanical premises, we believe that the restoration of the subtendons anatomy can lead to a better functional recovery of the Triceps Surae—Achilles Tendon complex, therefore we recently decided to adopt for open surgical repair the Direct Anatomical Reconstruction of the Achilles Tendon, which we describe in the present article.
format Article
id doaj-art-d1df4104f9a54997beb963455aa1567e
institution DOAJ
issn 2038-9582
language English
publishDate 2024-11-01
publisher MDPI AG
record_format Article
series Surgical Techniques Development
spelling doaj-art-d1df4104f9a54997beb963455aa1567e2025-08-20T02:50:43ZengMDPI AGSurgical Techniques Development2038-95822024-11-0113438239210.3390/std13040030Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon RupturesAlessandro Pisano0Gaetano Caruso1Department of Neurosciences and Rehabilitation, “S. Anna” University Hospital, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, “S. Anna” University Hospital, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy<b>Background/Objectives:</b> Acute ruptures of the Achilles Tendon (AT) are common injuries in the active population, in particular among men aged 30 to 50. Full functional recovery after this kind of injury is long and challenging and nowadays there is no universal “gold standard” strategy when dealing with them. <b>Methods:</b> When it comes to surgical treatment, various techniques have been described: in case of a typical lesion at the midportion of the tendon (which is the most common type), the basic principle of surgical repair is the end-to-end suture of the tendon stumps. The AT (“calcaneal tendon” according to the <i>International Anatomical Terminology</i>) is the strongest tendon of the human body, it is the conjunct tendon of the two Gastrocnemii Muscles and the Soleus Muscle and has a <b>well-recognizable twisted structure</b>: the subtendon from the Medial Head of the Gastrocnemius attaches postero-laterally on the calcaneal tendon footprint, the subtendon from the Lateral Head of the Gastrocnemius attaches antero-laterally and the subtendon from the Soleus attaches medially, therefore creating a 90° twist of the tendon structure. <b>Results: the twisted structure of the human AT is of central importance to its biomechanics</b>, since it gives the tendon a higher resistance to deformation and concurs in supination of the subtalar joint during gait. <b>Conclusions:</b> given the abovementioned anatomical and biomechanical premises, we believe that the restoration of the subtendons anatomy can lead to a better functional recovery of the Triceps Surae—Achilles Tendon complex, therefore we recently decided to adopt for open surgical repair the Direct Anatomical Reconstruction of the Achilles Tendon, which we describe in the present article.https://www.mdpi.com/2038-9582/13/4/30achilles tendonachilles tendon rupturecalcaneal tendonopen achilles tendon repairtriceps surae
spellingShingle Alessandro Pisano
Gaetano Caruso
Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures
Surgical Techniques Development
achilles tendon
achilles tendon rupture
calcaneal tendon
open achilles tendon repair
triceps surae
title Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures
title_full Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures
title_fullStr Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures
title_full_unstemmed Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures
title_short Direct Anatomical Reconstruction of the Achilles Tendon and Its Application for Surgical Treatment of Acute Achilles Tendon Ruptures
title_sort direct anatomical reconstruction of the achilles tendon and its application for surgical treatment of acute achilles tendon ruptures
topic achilles tendon
achilles tendon rupture
calcaneal tendon
open achilles tendon repair
triceps surae
url https://www.mdpi.com/2038-9582/13/4/30
work_keys_str_mv AT alessandropisano directanatomicalreconstructionoftheachillestendonanditsapplicationforsurgicaltreatmentofacuteachillestendonruptures
AT gaetanocaruso directanatomicalreconstructionoftheachillestendonanditsapplicationforsurgicaltreatmentofacuteachillestendonruptures