case_images: PMC11785353_01
case_images: Preoperative evaluation. . The examiner's index finger shows the palpable gap between the Achilles tendon stumps after an acute Achilles tendon rupture. The examiner may also notice a hematoma due to the recent injury, the hyperkeratosis of the heel as well as the cracking and flaking of the calf skin.
case_images: cureus-0017-00000076741-i01.jpg
case_images: PMC11785353_01_cureus-0017-00000076741-i01.jpg
case_images: FIG1
case_images: A 66-year-old male patient with AATR was referred to our department (Figures 1, 2).
case_images: Achilles tendon rupture diagnosis is confirmed with an ankle MRI.. Achilles tendon rupture is noted 4.4 cm proximal to the calcaneal insertion (arrow). The tendon stumps present minimal retraction. Increased intratendinous signal is indicative of some degree of Achilles noninsertional tendinopathy in T2 sequence.. MRI: Magnetic Resonance Imaging
case_images: cureus-0017-00000076741-i02.jpg
case_images: PMC11785353_01_cureus-0017-00000076741-i02.jpg
case_images: FIG2
case_images: A 66-year-old male patient with AATR was referred to our department (Figures 1, 2).
case_images: Intraoperative view of FHL harvesting.. (A) A towing suture (Vicryl) applies tension to the tendon and the soft tissue around it is debrided with the shaver. (B) A hamstring tendon stripper is introduced through the medial portal and embraces the FHL tendon. Then, it is forwarded into the fibro-osseous sheath to harvest 20mm of tendon length. Caution is required to avoid forceful thrusting of the stripper into the canal due to the risk of damaging the master knot of Henry and the medial plantar nerve.. L: Lateral, M: Medial, FHL: Flexor Hallucis Longus
case_images: cureus-0017-00000076741-i03.jpg
case_images: PMC11785353_01_cureus-0017-00000076741-i03.jpg
case_images: FIG3
case_images: Then, tension was applied to the FHL tendon through a towing Vicryl suture, and the tendon was harvested with a typical hamstring tendon stripper (Figures 3A, 3B).
case_images: (A) Postoperative lateral ankle radiograph. (B) Postoperative T2 MRI at 24-month follow-up.. Arrow 1 indicates the homogenous signal of the healed Achilles tendon. Arrow 2 depicts the transferred FHL tendon. Arrow 3 shows the fixation of the FHL with the bioabsorbable interference screw.. MRI: Magnetic Resonance Imaging, FHL: Flexor Hallucis Longus
case_images: cureus-0017-00000076741-i04.jpg
case_images: PMC11785353_01_cureus-0017-00000076741-i04.jpg
case_images: FIG4