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Achilles Peritendinitis - The Podiatry Institute

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Postoperative care generally consists of a below knee<br />

cast for approximately four weeks. At two weeks the cast<br />

is bivalved and the patient allowed to undergo gentle<br />

Iimited passive range of motion twice daily. At four<br />

weeks weight bearing is instituted in a guarded manner,<br />

at times with crutch assist and a slight heel raise. Physical<br />

therapy may be used to help stretch and strengthen the<br />

achilles. Activities progressively advance from walking,<br />

to cycling, and finally running.<br />

Cenerally the results following surgery have been<br />

reported as being very successful. One probably is curious<br />

as to whether or not the excision of a primary<br />

vascular supply such as the peritendon is advantageous.<br />

However, to date no later sequela have been published.<br />

As mentioned above, it is felt that the vascular ingrowth<br />

will later occur from surrounding tissues.<br />

References<br />

12.<br />

13.<br />

14.<br />

Lagergren C, Lindholm A: Vascular distribution on<br />

the achilles tendon - an angiographic and microangiographic<br />

study. Acta Chir Scand, 1 1 6:491 -<br />

495,1958.<br />

Cummins EJ, Anson Bl, Carr BW, Wright RR: <strong>The</strong><br />

structure of the calcaneal tendon (of achilles) in<br />

relation to orthopedic surgery. Surgery Gynecology<br />

Obstetrics, B3:107 , 1946.<br />

Sarrafian SK: Anatomy of the Foot and Ankle, )B<br />

Lippincott Co., Philadelphia, 1983, p.249.<br />

Puddu G, lppolito E, Postacchini F: A classification<br />

of achilles tendon disease. Am J Sports Med, 4:1 45-<br />

150,1976.<br />

Clement DB, Taunton JE, Smart CW:<strong>Achilles</strong> tendinitis<br />

and peritendinitis: etiology and treatment.<br />

Am J Sports Med, 12:179-184, 1984.<br />

Schepsis AA, Leach RE: Surgical management of<br />

achilles tendinitis. Am J Sports Med, 15:308-315,<br />

1987.<br />

Olivieri I, Gemignani C, Cherardi S, Crassi L,<br />

Ciompi ML: lsolated HLA-827 associated achilles<br />

tendinitis. Ann Rheumatic Dis, 46:626-627, 1987.<br />

Fox lM, Blaxina Me, Jobe FW, Kerlan RK, Carter VS,<br />

Shields CL, Carlson CJ: Degeneration and rupture<br />

of the achilles tendon. Clin Orthop,lOT:221-224,<br />

1975.<br />

)ozsa L, Kvist M, Balint BJ, Reffy A, Jarvined M,<br />

Lehto M, Barzo M: <strong>The</strong> role of recreational sport activity<br />

in achilles tendon rupture. Am J Sports Med,<br />

17:338-343, 1989.<br />

Fiamengo SA, Warren RF, MarshallJL, Vigorita VT,<br />

Hersh A: Posterior heel pain associated with a calcaneal<br />

step and achilles tendon calcification. C/in<br />

O.rthop, 167 :203-211 , 1982.<br />

Downey MS, Kalish SK: Surgical excision and repair<br />

of calcifications of the tendo achillis. Surgery<br />

of the Foot and Leg, 1986, McGlamry ED, (ed.),<br />

Pod iatry lnstitute Publish ing Co., Tucker, CA,<br />

'l<br />

986, pp.1 34-139.<br />

Leach RE, James S, Wasilewski S: <strong>Achilles</strong> tendinitis.<br />

Am J Sports Med,9:93-98, 1981.<br />

Clancy WG, Neidhart D, Brand RL: <strong>Achilles</strong> tendonitis<br />

in runners: A report of five cases. Am J<br />

Sports Med, 4:46-57, 1976.<br />

Gould N, Korson R: Stenosing tenosynovitis of the<br />

pseudosheath of the tendo achilles. Foot Ankle,<br />

1:179-187 , 1980.<br />

2.<br />

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216

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