Our Experience with Achilles Tendon Reconstruction with Semitendinosus Graft Wrapped in Fascia Lata

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Author(s): 1. Touqeer Hussain, 2. Fahad Hanif Khan, 3. Mirza Shehab Afzal Beg

Received: 16/03/2022 | Published: 27/08/2022 | Pages: 70-73 |

Background: Achilles’ tendon rupture leads to significant disability causing abnormal gait. With time, the cut ends of the tendo-Achilles retract creating a huge gap in between which needs reconstruction by a tendon graft like semitendinosus, gracilis, flexor hallucis longus tendon, and tensor fascia lata. However, they are not sturdy enough to replace the powerful Achilles tendon. We used a novel technique to make a suitable replacement for the Achilles’ tendon in which the semitendinosus tendon was wrapped in fascia lata and this combination was used to bridge the gap between cut ends of the Achilles tendon. Methodology: All the patients who presented with chronic Achilles tendon injury (>6weeks of injury) from Jan 2017 to Dec 2020 were included. The gap between the retracted ends of tendo-Achilles was bridged by semitendinosus tendon wrapped in fascia lata. The postoperative splint was given on the anterior leg in a plantar flexed position for 6 weeks which gradually converted to 90 degrees of ankle flexion. MRC grade of ankle plantar flexion and gait of the patient was observed at 12 weeks and 6 months postoperatively. Results: Five patients were operated on in four years. The average MRC grade at 12 weeks post-operative was 3 which increased to 5 in all patients at 6 months with the help of post operative physiotherapy. Observed gait was normal at 6 months of 4 patients and near-normal of 1 patient. Conclusion: Further reinforcement of semitendinosus graft with fascia lata is an innovative technique that constitutes a strong and tough substitute for a broken Achilles tendon.

Keywords | Achilles’ tendon, Fascia Lata, Reconstructive Surgical Procedures, Tendon graft.