J Korean Orthop Assoc.  2022 Dec;57(6):490-496. 10.4055/jkoa.2022.57.6.490.

Clinical Outcome of V-Y Advancement Flap for Chronic Achilles Tendon Rupture

Affiliations
  • 1Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea
  • 2Department of Orthopaedic Surgery, Gwangju Suwan Hospital, Gwangju, Korea

Abstract

Purpose
Chronic Achilles tendon rupture with a 2–5 cm gap is usually repaired using a V-Y advancement flap. This study examined the clinical outcomes after a V-Y advancement flap for a chronic Achilles tendon rupture and compared the postsurgical muscle strength of the affected limb with the unaffected side using a constant velocity dynamometer.
Materials and Methods
Twenty patients (14 male, six female) who underwent a V-Y advancement flap for chronic Achilles tendon rupture between March 2011 and September 2019 were reviewed retrospectively. The following clinical outcomes were evaluated preinjury, preoperatively, and postoperatively: the Foot and Ankle Ability Measure (FAAM) daily living and sports subscales, Thermann score, American Orthopaedic Foot and Ankle Society score, and Achilles Tendon Total Rupture Score. At the last follow-up, the muscle torque at an ankle plantar flexion of 30°, 60°, and 120° was measured on both sides using a constant velocity dynamometer (HUMAC ® ) to determine the gastrocnemius-soleus complex strength.
Results
The postoperative average deficiency of plantar flexion strength in the affected side was 10.40% for plantar flexion peak torque at 30°/s, and 15.89% for peak torque at 120°/s. The mean FAAM daily living subscale improved to 98.81±1.54 from 94.28±5.48 pre-injury (p<0.001). On the other hand, the mean FAAM sports subscale decreased to 85.28±4.47 from 95.71±4.27 pre-injury (p<0.001).
Conclusion
Chronic Achilles tendon rupture repair by a V-Y advancement flap leads to successful return to pre-injury daily life activities without additional treatment.

Keyword

Achilles tendon; chronic Achilles tendon rupture; V-Y advancement flap; isokinetic dynamometry; muscle strength
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