Sonographic assisted diagnosis and treatment of bilateral gastrocnemius tendon rupture in a Labrador retriever repaired with fascia lata and polypropylene mesh

J. Swiderski; R. B. Fitch; A. Staatz; J. Lowery

doi:10.1055/s-0038-1632955

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 2005; 18(04): 258-263
DOI: 10.1055/s-0038-1632955

Case Report

Schattauer GmbH

Sonographic assisted diagnosis and treatment of bilateral gastrocnemius tendon rupture in a Labrador retriever repaired with fascia lata and polypropylene mesh

Authors

J. Swiderski

¹Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
R. B. Fitch

¹Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
A. Staatz

¹Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
J. Lowery

¹Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA

Abstract

Summary

This case report describes a four-year-old, eighty-five pound, male neutered Labrador retriever that was admitted with unilateral lameness and clinical findings consistent with a unilateral gastrocnemius tendon rupture. A prior history of trauma was not identified. Ultrasonagraphic evaluation revealed bilateral gastrocnemius tendon defects in which approximately 80% of the tendon was ruptured on the clinically normal side, yet mechanical function and anatomical length were not apparently altered. Bilateral surgical repair was performed utilizing primary tendon reconstruction, supported by fascia lata, autograft and polypropylene mesh. The repairs were protected with rigid casts for two weeks following surgery, and replaced with orthotics through the complete recovery period. Orthotics provided semi-rigid support and allowed removal for controlled intermittent physical therapy. This surgical repair technique, combined with orthotic support, allowed for early mobilization and good ultimate outcome for a complicated bilateral condition.

Keywords

Gastrocnemius tendon - common calcanean tendon - Achilles tendon - fascia lata - polypropylene mesh - orthotic

Volltext

Referenzen

References
1 Gilmore D. Use of Barbed steel sutures for Repair of Calcaneal Tendon Rupture. J Am Vet Med Assoc 1984; 20: 408-12.
2 Sivccolundhu R, Marchevsky A, Read R. et al. Achilles mechanism reconstruction in four dogs. Vet Comp Orthop Traumatol 2001; 14: 25-31.
3 Paavola M, Paakkala T, Kannus P. et al. Ultrasound in the differential diagnosis of Achilles tendon injuries and related disorders. A comparison between pre-operative ultrasonography and surgical findings. Acta Radiol 1998; 39 (6) 612-9.
4 Kainberger F, Engal A, Barton Petal. Injury of the Achilles tendon: diagnosis with sonography. Am J Roentgenol 1990; 155 (5) 1031-6.
5 Hartgerink P, Fessell D, Jacobson J. et al. Full-versus partial-thickness Achilles tendon tears: sonographic accuracy and characterization in 26 cases with surgical correlation. Radiology 2001; 220 (2) 406-12.
6 Kalebo P, Allenmark C, Peterson L. et al. Diagnostic value of ultrasonography in partial ruptures of the Achilles tendon. Am J Sports Med 1992; 20 (4) 378-81.
7 Kramer M, Gersing M, Hack V. et al. Sonography of musculoskeletal system in dogs and cats. Vet Rad 1997; 38 (2) 139-49.
8 Reinke J, Mughannam A, Owens J. Avulsion of the gastrocnemius tendon in 11 dogs. J Am Anim Hosp Assoc 1993; 29: 410-8.
9 Shani J, Shahar R. Repair of Chronic Complete Traumatic Rupture of the Common Calcaneal Tendon in a Dog, Using a Fascia Lata Graft. Vet Comp Orthop Traumatol 2000; 13: 104-8.
10 Braden T. Fascia Lata Transplant for Repair of Chronic Achilles Tendon Defects. J Am Anim Hosp Assoc 1976; 12: 800-5.
11 Tomlinson J, Moore R. Locking Loop Tendon Suture use in Repair of Five Calcanean Tendons. J VetSurg 1982; 11: 105-11.
12 Guerin S, Burbidge H, Firth E. et al. Achilles Tenorrhaphy in Five Dogs: A Modified Surgical Technique and Evaluation of Cranial Half Cast. Vet Comp Orthop Traumatol 1998; 11: 205-10.
13 Morshead D, Leeds E. Kirshner-Ehmer apparatus immobilization following tendon repair. Vet Surg 1984; 13 (1) 11-14.
14 Boneau N, Olivre M, Berton L. Avulsion of the Gastrocnemius Tendon in the Dog Causing Flexion of the Hock and Digits. J Am Anim Hosp Assoc 1993; 19: 717-22.
15 Choksey A, Soonawalla D, Murray J. Repair of neglected Achilles tendon ruptures with Marlex mesh. Injury 1996; 27 (3) 215-7.
16 Ozaki J, Fujiki J, Sugimoto K. et al. Reconstruction of neglected Achilles tendon rupture with Marlex mesh. Clin Orthop 1989; 238: 204-8.
17 Fernandez-Fairen M, Gimeno C. Augmented repair of Achilles tendon ruptures. Am J Sports Med 1977; 25 (2) 177-81.
18 Kuwada G. A severe acute Achilles rupture and repair. J Foot Ankle Surg 1995; 34 (3) 262-6.
19 Carter T, Fowler P, Blokker C. Functional postoperative treatment of Achilles tendon repair. Am J Sports Med 1992; 20 (4) 459-62.
20 Troop R, Losse G, Lane J. et al. Early motion after repair of Achilles tendon ruptures. Foot Ankle Int 1995; 16 (11) 705-9.
21 Deiler S, Pfadenhauer A, Widmann H. et al. Tensor fascae lata perforator flap for reconstruction of composite Achilles tendon defects with skin andvascularized fascia. Plast Reconstr Surg 2000; 106 (2) 342-9.
22 Lee K, Weiss A. Xanthomas of the Achilles tendons. A case report ofbilateral total resection and tendon reconstruction using the fascia lata. J Bone Joint Surg Am 1980; 62 (4) 666-9.
23 Taniguchi Y, Tamaki T. Reconstruction of the Achilles tendon and overlying skin defect with a medical plantar flap and tensor fasciae lata graft. J Reconstr Microsurg 2000; 16 (6) 423-25.
24 Fox S, Woody B, Bright R. et al. Reconstruction of tissue defects with Marlex mesh. Comp Cont Ed 1988; 10 (8) 897-904.
25 Montgomery R. Healing ofmuscle, ligaments and tendons. SemVet Med Surg 1989; 4 (4) 304-11.
26 Kuwada G. An update on repair of Achilles tendon rupture. Acute and delayed. J Am Podiatr Med Assoc 1989; 89 (6) 302-6.
27 Kissel C, Blacklidge D, Crowley D. Repair of Neglected Achilles Tendon Ruptures – Procedure and Functional Results. J Foot Ankle Surg 1994; 33 (1) 46-52.
28 Robello G, Aron D, Foutz T. et al. Replacement of the medial collateral ligament with polypropylene mesh or apolyester suture in dogs. Vet Surg 1992; 21 (6) 467-76.
29 Hosey G, Kowalchick E, Tesoro D. et al. Comparison of the mechanical and histologic properties of Achilles tendons in New Zealand white rabbits secondarily repaired with Marlex mesh. J Foot Surg 1991; 30 (3) 214-233.
30 Trostle S, Rosin E. Selection of prostheticmeshim-plants. Compend Cont Ed 1994; 16 (9) 1147-55.
31 Pneumaticos S, McGarvey W, Mody D. et al. The effects of early mobilization in the healing of Achilles tendon repair. Foot Ankle Int 2000; 21 (7) 551-7.
32 Mandelbaum B, Myerson M, Forster R. Achilles tendon ruptures. A new method of repair, early range of motion, and functional rehabilitation. Am J Sports Med 1995; 23 (4) 392-5.
33 Mortensen N, Skov O, Jensen P. Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study. J Bone Joint Surg Am 1999; 81 (7) 983-990.
34 Keller W, Aron D, Rowland G. et al. The effects of trans-stifle eternal skeletal fixation and hyaluronic acid therapy on articular cartilage in the dog. VetSurg 1994; 23 (2) 119-28.
35 Behrens F, Kraft E, Oegema T. Biomechanical changes in articular cartilage after joint immobilization by casting or external fixation. J Orthop Res 1989; 7 (3) 335-43.
36 Saamanes A, Tammi M, Jurvenlin J. et al. Proteoglycan alterations following immobilization and re-mobilization in the articular cartilage of young canine knee (stifle) joint. J Orthop Res 1990; 8 (6) 863-73.
37 Haapala J, Arokoski J, Hyttinen M. et al. Remobilization does not fully restore immobilization induced articular cartilage atrophy. Clin Orthop 1999; 362: 218-29.