Journal ID : CJOHNS-08-08-2023-11378
[This article belongs to Volume - 54, Issue - 05]

Title : Good Functional Outcome in Non-Insertional Achilles Tendinopathy After Open Surgery with FHL Tendon Augmentation in Large Defects: A Case Report

Abstract :

Achilles tendinopathy is caused by the merge of gastrocnemius and soleus tendon in the back side of the calf. Imaging serves as a role in diagnosis and treatment. Surgery removes degenerative tissue, induces tendon regeneration, and augments the Achilles tendon with grafts. We report a 46-year-old female came to Saiful Anwar Hospital with a sustainable pain and couldn't do a normal plantar flexion on the right foot. The pain in the right heel has been experienced since 2010, with a history of daily boot wearer since 2004. The physical examination shows no sign of infection; tenderness appeared at the posterior side of the right ankle. The imaging showed a calcaneal spur with calcified tendinopathy Achilles on the right ankle. MRI showed a thickened Achilles tendon. The patient has approximately 70% tendinopathy area, treated with an open surgical approach with longitudinal tenotomy and FHL augmentation with Allgӧwer-Donati method suture closure. The patient has remarkable results with an average improvement of plantarflexion movement is 53˚ and dorsoflexion is 20˚ on measurement. The good functional outcome has been measured with a reliable instrument named the FAAM score, depending on the patient's perspective for her desired outcome. FAAM score six months after surgery had significantly improved from 50% to 25% of impairment. Open surgical approach, longitudinal tenotomy, FHL augmentation, Allgöwer–Donati technique, and rehabilitation improve functional outcomes by FAAM score, which is the most appropriate tool to quantify functional disabilities.

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