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ACHILLES HEEL
SURGICAL
COMPLICATIONS
DR MOHAMED ASHRAF
PROF & HOD
TRAVANCORE MEDICAL COLLEGE,KOLLAM
ACHILLES TENDON
A VULNERABLE 皆永或意
SEEMINGLY SIMPLE INJURY.,
SIMPLE SURGERY
BUT MAY LAND UP IN DEEP TROUBLE
MAY BE A SIMPLE SUTURE REACTION
OR SUPERFICIAL SSI
DEEP SSI WITH MINIMAL SKIN
SLOUGHING
SUPERFICIAL TENDON SLOUGHING
TOTAL TENDON SLOUGHING
TREATMENT OPTIONS
 INSIDE SUTURE REMOVAL
 GOOD DEBRIDEMENT
 PRIMARY CLOSURE
VAC / NPWT
SSG
 S S G
LOCAL FLAP
 flap
FREE FLAP
ANTIBIOTIC BEADS
TREATMENT OPTIONS
ARTHROSCOPIC DEBRIDEMENT
RE-RUPTURE
NEGLECTED TEAR-
FUNCTIONALOUTCOME
IN GAP
IN SCARBRIDGE
OPTION-1
END TO END
OPTION -2
END TO END WITH TRICEPS
LENGTHENING
OPTION -3
END TO END WITH AUGMENTATION
OPTION  4
TENDON TRANSFERS
FHL
OPTION -5
AUTOGRAFT
ALLOGRAFT
OPTION -6
SYNTHETIC SCAFFOLDS
WHATS NEW
TISSUE ENGINEERING
WHATS NEW
TISSUE EXPANDERS
SURAL NERVE INJURY
COMPLICATION PREVENTION
 BE A GENTLE AND DELICATE SURGEON
LIMITED / INTERRUPTED/ACHILLON
EXPOSURE
PERFORM A STABLE REPAIR TECHNIC
TRY TO CLOSE PARATENON
MY ALGORITHM
 OPEN INJURY- END TO END REPAIR
 CLOSED INJURY ELDERLY UPTO 4 WEEKS- POP
 CLOSED INJURY YOUNG  END TO END REPAIR
 CLOSED INJURY YOUNG NEGLECTED- END TO END WITH V-Y PLASTY
 ANY TEAR WITH HAGELUND HUMP  HUMP EXCISION
 ALL NEGLECTED RUPTURES- TRANSCALCANEAL SS WIRING
PREVENTION OF
COMPLICATIONS
 BE A MINIMALIST
 BE A SOFT TISSUE SURGEON
 LEARN ARTHROSCOPIC TECHNICS
MY OWN EXPERIENCE
THANK YOU

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TENDO_ACHILLES-SURGICAL_OPTIONS.pptx- -author -dr Mohamed ashraf,professor and head of ORTHOPAEDICS, travancore medical College and MEDICITY HOSPITALS Kollam Kerala India