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which is the ideal method to reconstruct achilles tendons following debridement of sloghed tendons in ulers involving tendoachilles area?

 

Dear Dr:

I suppose it depends on your goals. In many cases, the most important thing is to get the wound healed-- Achilles function, while important, is secondary. Often, the Achilles will tack down to soft tissue in the area and give a bit of plantarflexion even in the absence of any specific intervention. When we repair, we usually use an acellular matrix to bolster it.

I hope this helps...




David G. Armstrong, DPM, MD, PhD
Professor of Surgery and Director
Southern Arizona Limb Salvage Alliance (SALSA)
University of Arizona College of Medicine
+1 520 305 9393 (voice/text)

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thank you sir,
it is a great honour to get an answer from someone of your stature.
i had assumed that tendon reconstruction procedures were to be used similar to those used for acute traumatic ruptures.we often end up resecting the tendon and part of gastrocnemius following debridement.this is usually followed by a skin graft which if fails we ask the plastic surgeons to give us a pedicled or microvascular flap.though i have been only in podiatry for a month i have seen some who present with metatarsal head or heel ulcers probably which my guide dr ajith varma explains is due to incorrect length of achilles tendon.

 

sir ,
what is ur experience with PMMA-ALC beads in open infected ankle and knee joints??is it necessary that the beads be removed ??can PMMA -ALC powder granules (which formed when i was not quick enuf to roll beads from the PMMA powder) be sprinkled in the infected joint to allow for prolonged release of antibiotics?