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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

J. Swiderski
1   Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
,
R. B. Fitch
1   Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
,
A. Staatz
1   Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
,
J. Lowery
1   Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
› Author Affiliations
Further Information

Publication History

Received 12 February 2003

Accepted 02 May 2005

Publication Date:
22 February 2018 (online)

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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
 

  • References

  • 1 Gilmore D. Use of Barbed steel sutures for Repair of Calcaneal Tendon Rupture. J Am Vet Med Assoc 1984; 20: 408-12.
    PubMedSearch in Google Scholar
  • 2 Sivccolundhu R, Marchevsky A, Read R. et al. Achilles mechanism reconstruction in four dogs. Vet Comp Orthop Traumatol 2001; 14: 25-31.
    Thieme ConnectPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 4 Kainberger F, Engal A, Barton Petal. Injury of the Achilles tendon: diagnosis with sonography. Am J Roentgenol 1990; 155 (5) 1031-6.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 7 Kramer M, Gersing M, Hack V. et al. Sonography of musculoskeletal system in dogs and cats. Vet Rad 1997; 38 (2) 139-49.
    CrossrefPubMedSearch in Google Scholar
  • 8 Reinke J, Mughannam A, Owens J. Avulsion of the gastrocnemius tendon in 11 dogs. J Am Anim Hosp Assoc 1993; 29: 410-8.
    PubMedSearch in Google Scholar
  • 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.
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Braden T. Fascia Lata Transplant for Repair of Chronic Achilles Tendon Defects. J Am Anim Hosp Assoc 1976; 12: 800-5.
    PubMedSearch in Google Scholar
  • 11 Tomlinson J, Moore R. Locking Loop Tendon Suture use in Repair of Five Calcanean Tendons. J VetSurg 1982; 11: 105-11.
    PubMedSearch in Google Scholar
  • 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.
    Thieme ConnectPubMedSearch in Google Scholar
  • 13 Morshead D, Leeds E. Kirshner-Ehmer apparatus immobilization following tendon repair. Vet Surg 1984; 13 (1) 11-14.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 15 Choksey A, Soonawalla D, Murray J. Repair of neglected Achilles tendon ruptures with Marlex mesh. Injury 1996; 27 (3) 215-7.
    CrossrefPubMedSearch in Google Scholar
  • 16 Ozaki J, Fujiki J, Sugimoto K. et al. Reconstruction of neglected Achilles tendon rupture with Marlex mesh. Clin Orthop 1989; 238: 204-8.
    CrossrefPubMedSearch in Google Scholar
  • 17 Fernandez-Fairen M, Gimeno C. Augmented repair of Achilles tendon ruptures. Am J Sports Med 1977; 25 (2) 177-81.
    PubMedSearch in Google Scholar
  • 18 Kuwada G. A severe acute Achilles rupture and repair. J Foot Ankle Surg 1995; 34 (3) 262-6.
    CrossrefPubMedSearch in Google Scholar
  • 19 Carter T, Fowler P, Blokker C. Functional postoperative treatment of Achilles tendon repair. Am J Sports Med 1992; 20 (4) 459-62.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Fox S, Woody B, Bright R. et al. Reconstruction of tissue defects with Marlex mesh. Comp Cont Ed 1988; 10 (8) 897-904.
    PubMedSearch in Google Scholar
  • 25 Montgomery R. Healing ofmuscle, ligaments and tendons. SemVet Med Surg 1989; 4 (4) 304-11.
    PubMedSearch in Google Scholar
  • 26 Kuwada G. An update on repair of Achilles tendon rupture. Acute and delayed. J Am Podiatr Med Assoc 1989; 89 (6) 302-6.
    PubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 30 Trostle S, Rosin E. Selection of prostheticmeshim-plants. Compend Cont Ed 1994; 16 (9) 1147-55.
    PubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    CrossrefPubMedSearch in Google Scholar
  • 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.
    PubMedSearch in Google Scholar