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CC BY 4.0 · VCOT Open 2020; 03(02): e84-e89
DOI: 10.1055/s-0040-1715135
Case Report

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

Sergio Minei
1   Surgical Department, Ospedale Veterinario Santa Fara, Bari, Italy
,
Filippo Cinti
1   Surgical Department, Ospedale Veterinario Santa Fara, Bari, Italy
,
Brunella Pompei
1   Surgical Department, Ospedale Veterinario Santa Fara, Bari, Italy
,
Paolo Abrescia
1   Surgical Department, Ospedale Veterinario Santa Fara, Bari, Italy
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Abstract

A 9-year-old, intact male, German wirehaired pointer was referred for suspected Achilles tendon rupture 3 weeks after an injury. A three-loop pulley suture pattern combined with a locking loop suture reduced the gap between the tendon ends to 7 mm and a central gastrocnemius turnover aponeurotic flap was used to cover the remaining gap. A type II free-form methyl methacrylate transarticular external skeletal fixator was used to keep the tarsocrural joint in extension until 45 days postoperatively. Short- and long-term clinical and ultrasonographic evaluations showed gradual improvement in weight-bearing and progressive tendon healing. At 6 months after surgery, the dog had normal limb function and had returned to the previous activity level. To the authors' knowledge, this tendon repair technique has been described in humans and in one cat but has not yet been reported in dogs.

Keywords

gastrocnemius muscle - tendon healing - dogs - Achilles tendon - augmentation technique


Publication History

Received: 17 February 2020

Accepted: 28 June 2020

Article published online:
30 August 2020

© .

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Corr SA, Draffan D, Kulendra E, Carmichael S, Brodbelt D. Retrospective study of Achilles mechanism disruption in 45 dogs. Vet Rec 2010; 167 (11) 407-411
    CrossrefPubMedGoogle Scholar
  • 2 King M, Jerram R. Achilles tendon rupture in dogs. Compend Contin Educ Pract Vet 2003; 25: 613-620
    PubMedGoogle Scholar
  • 3 Maffulli N. Rupture of the Achilles tendon. J Bone Joint Surg Am 1999; 81 (07) 1019-1036
    CrossrefPubMedGoogle Scholar
  • 4 Worth AJ, Danielsson F, Bray JP, Burbidge HM, Bruce WJ. Ability to work and owner satisfaction following surgical repair of common calcanean tendon injuries in working dogs in New Zealand. N Z Vet J 2004; 52 (03) 109-116
    CrossrefPubMedGoogle Scholar
  • 5 Nielsen C, Pluhar GE. Outcome following surgical repair of Achilles tendon rupture and comparison between postoperative tibiotarsal immobilization methods in dogs: 28 cases (1997-2004). Vet Comp Orthop Traumatol 2006; 19 (04) 246-249
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Sivacolundhu RK, Marchevsky AM, Read RA. , et al. Achilles mechanism reconstruction in four dogs. Vet Comp Orthop Traumatol 2001; 14: 25-31
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Carmichael S, Marshall WG. Muscle and tendon disorders. In: Johnston SA, Tobias KM. , eds. Veterinary Surgery: Small Animal Expert Consult. Vol 1. 2nd edition. St Louis, MO: Elsevier; 2018: 1319-1323
    Google Scholar
  • 8 Maffulli N, Ajis A. Management of chronic ruptures of the Achilles tendon. J Bone Joint Surg Am 2008; 90 (06) 1348-1360
    CrossrefPubMedGoogle Scholar
  • 9 Guerin S, Burbidge HM, Firth E, Fox S. Achilles tenorrhaphy in five dogs: a modified surgical technique and evaluation of a cranial half cast. Vet Comp Orthop Traumatol 1998; 11 (04) 205-210
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Morshead D, Leeds EB. Kirschner–Ehmer apparatus immobilization following Achilles tendon repair in six dogs. Vet Surg 1984; 13: 11-14
    CrossrefPubMedGoogle Scholar
  • 11 deHaan JJ, Goring RL, Renberg C. Modified transarticular external skeletal fixation for support of Achilles tenorrhaphy in four dogs. Vet Comp Orthop Traumatol 1995; 8: 32-35
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Norton J, Decamp C, Yu J, Rooks R. Use of a single-ring transarticular fixator construct for immobilisation of the talocrural joint following common calcaneal tenorrhaphy. Vet Comp Orthop Traumatol 2009; 22 (05) 430-435
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Moores AP, Comerford EJ, Tarlton JF, Owen MR. Biomechanical and clinical evaluation of a modified 3-loop pulley suture pattern for reattachment of canine tendons to bone. Vet Surg 2004; 33 (04) 391-397
    CrossrefPubMedGoogle Scholar
  • 14 Wilson L, Banks T, Luckman P, Smith B. Biomechanical evaluation of double Krackow sutures versus the three-loop pulley suture in a canine gastrocnemius tendon avulsion model. Aust Vet J 2014; 92 (11) 427-432
    CrossrefPubMedGoogle Scholar
  • 15 Schulz KS, Ash KJ, Cook JL. Clinical outcomes after common calcanean tendon rupture repair in dogs with a loop-suture tenorrhaphy technique and autogenous leukoreduced platelet-rich plasma. Vet Surg 2019; 48 (07) 1262-1270
    CrossrefPubMedGoogle Scholar
  • 16 Putterman AB, Duffy DJ, Kersh ME, Rahman H, Moore GE. Effect of a continuous epitendinous suture as adjunct to three-loop pulley and locking-loop patterns for flexor tendon repair in a canine model. Vet Surg 2019; 48 (07) 1229-1236
    CrossrefPubMedGoogle Scholar
  • 17 Gelberman RH, Boyer MI, Brodt MD, Winters SC, Silva MJ. The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs. J Bone Joint Surg Am 1999; 81 (07) 975-982
    CrossrefPubMedGoogle Scholar
  • 18 Baltzer WI, Rist P. Achilles tendon repair in dogs using the semitendinosus muscle: surgical technique and short-term outcome in five dogs. Vet Surg 2009; 38 (06) 770-779
    CrossrefPubMedGoogle Scholar
  • 19 Gilbert TW, Stewart-Akers AM, Simmons-Byrd A, Badylak SF. Degradation and remodeling of small intestinal submucosa in canine Achilles tendon repair. J Bone Joint Surg Am 2007; 89 (03) 621-630
    CrossrefPubMedGoogle Scholar
  • 20 Katayama M. Augmented repair of an Achilles tendon rupture using the flexor digitorum lateralis tendon in a toy poodle. Vet Surg 2016; 45 (08) 1083-1086
    CrossrefPubMedGoogle Scholar
  • 21 Diserens KA, Venzin C. Chronic Achilles tendon rupture augmented by transposition of the fibularis brevis and fibularis longus muscles. Schweiz Arch Tierheilkd 2015; 157 (09) 519-524
    CrossrefPubMedGoogle Scholar
  • 22 Perry BS, Harper TA, Mitchell MA, McFadden MS, Heggem Perry B. Barbed versus smooth poly-propylene three-loop pulley sutures for repair of canine gastrocnemius tendon. Vet Comp Orthop Traumatol 2014; 27 (06) 436-440
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Swiderski J, Fitch RB, Staatz A, Lowery J. Sonographic assisted diagnosis and treatment of bilateral gastrocnemius tendon rupture in a Labrador retriever repaired with fascia lata and polypropylene mesh. Vet Comp Orthop Traumatol 2005; 18 (04) 258-263
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Zellner EM, Hale MJ, Kraus KH. Application of tendon plating to manage failed calcaneal tendon repairs in a dog. Vet Surg 2018; 47 (03) 439-444
    CrossrefPubMedGoogle Scholar
  • 25 Morton MA, Thomson DG, Rayward RM, Jiménez-Peláez M, Whitelock RG. Repair of chronic rupture of the insertion of the gastrocnemius tendon in the dog using a polyethylene terephthalate implant. Early clinical experience and outcome. Vet Comp Orthop Traumatol 2015; 28 (04) 282-287
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Vaughan LC. The use of carbon fibre implants for the repair of Achilles tendon rupture in dogs. J Small Anim Pract 1981; 22 (10) 629-634
    CrossrefPubMedGoogle Scholar
  • 27 Gandin J, Baud G. [21 operated cases of rupture of the Achilles tendon]. Mem Acad Chir (Paris) 1961; 87: 706-710
    PubMedGoogle Scholar
  • 28 Gerdes MH, Brown TD, Bell AL, Baker JA, Levson M, Layer S. A flap augmentation technique for Achilles tendon repair. Postoperative strength and functional outcome. Clin Orthop Relat Res 1992; (280) 241-246
    PubMedGoogle Scholar
  • 29 Sangion F, Cinti F, Pisani G. Common Calcaneal tenorrhaphy revision using a central gastrocnemius turnover aponeurotic flap technique in a cat. Vet Comp Orthop Traumatol 2018; 31 (01) 67-70
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Kramer M, d'Anjou MA. Musculoskeletal system. In: Penninck D, d'Anjou MA. , eds. Atlas of Small Animal Ultrasonography. First edition. Ames, Iowa: Blackwell Pub; 2008: 465-508
    Google Scholar