Use of a Central Splitting Approach and Near Complete Detachment  for  Insertional XXXX Repaired  With an Achilles Bridging Suture.

@entity730 @entity1 @entity158
UNASSIGNED: After 3 to 6 months of conservative management for insertional @entity730 , operative intervention might be warranted. Despite a success rate of 75% to 100% with surgery, no consensus has been reached on the amount of acceptable detachment of the Achilles tendon. The present case series reports on the results of a central splitting approach with 80% to 90% detachment of the Achilles insertion repaired with a double-row bridging suture device. A total of 14 @entity1 (16 heels) for whom nonoperative management for insertional @entity730 had previously failed were enrolled in the present study they had undergone surgical management. The @entity1 were followed up for a mean of 18 (range 11 to 25) months postoperatively and were evaluated using the American Orthopaedic Foot and Ankle Society Hind Foot scoring system, 36-item Short Form Health Survey questionnaire, and pre- and postoperative visual analog @entity158 scale. The mean visual analog @entity158 scale core had decreased 5.84 (range 1 to 9) points postoperatively (p < .001). The mean postoperative American Orthopaedic Foot and Ankle Society Hind Foot score was 87      19.7 (range 52 to 105) points. One @entity1 reported moderate @entity158 with no limitation of activities. The mean 36-item Short-Form Health Survey score for physical functioning was 77.7 (range 30 to 100) points postoperatively in 11 @entity1 . No @entity1 reported incisional discomfort. All 14 @entity1 (16 heels) reported being satisfied and had returned to their previous functional status. Thus, the central splitting Achilles approach with anchoring of the Achilles insertion using the double-row suture device is a safe and reasonable option in the operative treatment of insertional @entity730 .
