Summary
Chronic Achilles mechanism injuries require aggressive treatment with excision of
degenerate tissue. Following excision of degenerate tendon, the defect created may
be too large to allow simple apposition of tendon to bone. Use of peroneus brevis
and peroneus longus tendon transpositions (passing through bone tunnels drilled in
the calcaneus), +/− lengthening of the gastrocnemius tendon, and reinforcement with
a free fascial strip graft allows reconstruction of the area. Postoperative support
should be provided using a type II transarticular external fixator for four weeks,
followed by a splint or Robert Jones bandage for three weeks. Treatment, in all four
of the dogs in this report, resulted in a good to excellent outcome. Based on the
favourable results in this series, resection of all grossly abnormal tendon should
be considered in cases of Achilles mechanism rupture, even though reconstruction of
the area is more complex.
Five Achilles mechanism reconstructions were performed in four dogs with chronic injury
to the tendon. Following excision of degenerate tendon the area was reconstructed,
in each case using peroneus brevis and peroneus longus tendon transpositions, lengthening
of the gastrocnemius tendon and reinforcement with a free fascial strip graft. Post-operative
support was provided in the form of a type II trans-articular external fixator for
four to five weeks, followed by a splint or Robert Jones bandage for two to three
weeks. The results in all of the dogs were good to excellent. One dog returned to
full working capacity. Two dogs returned to unrestricted exercise without any observable
lameness. One dog (bilateral injury) is sound but the owners have decided to limit
the dog’s access to unrestricted activity.
Keywords
Achilles mechanism - Achilles tendon - peroneus brevis - peroneus longus - fascial
strip graft - dog
