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Extensile posterior approach to the ankle with detachment of the achilles tendon for oncologic indications.

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Citation: Foot & Ankle International. 33(5):430-5, 2012 May.PMID: 22735287Institution: MedStar Washington Hospital CenterDepartment: Orthopedic OncologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Achilles Tendon/su [Surgery] | *Ankle Joint/su [Surgery] | *Bone Neoplasms/su [Surgery] | *Chondroblastoma/su [Surgery] | *Orthopedic Procedures/mt [Methods] | *Synovitis, Pigmented Villonodular/su [Surgery] | Adult | Child | Female | Follow-Up Studies | Humans | Male | Middle Aged | Patient Satisfaction | Postoperative Complications | Retrospective Studies | Suture AnchorsLocal holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006ISSN:

1071-1007

Name of journal: Foot & ankle international. / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle SocietyAbstract: BACKGROUND: We describe an extensile posterior approach to the ankle with detachment of the Achilles tendon for resection of extensive tumors involving the posterior ankle. To the best of our knowledge, this approach and its results have not been reported for oncologic indications.CONCLUSION: Excellent exposure, tumor control and patient function were achieved by this approach in a select group of patients. The surgical technique described in this report offers another alternative for an extensile posterior approach to the ankle and/or subtalar joints.METHODS: The surgical technique involved detachment of the Achilles tendon, tumor resection and reconstruction of the Achilles tendon with anchor sutures, and was used in six patients. The diagnosis was pigmented villonodular synovitis (5) and chondroblastoma (1).RESULTS: At a mean of 6 (range, 2 to 10) years followup, all patients were free from tumor. All patients could walk an unlimited amount without any support. There were no problems with Achilles incompetence. The mean Musculoskeletal Tumor Society score was 97 +/- 4.2% (range, 90 to 100) and the mean Achilles Tendon Total Rupture Score was 95 +/- 5.7 (range, 87 to 100). One patient with screwed suture anchors had backing out of two anchors along with deep infection, requiring surgical debridement and anchor removal. One other patient had a post-traumatic small wound dehiscence which responded to local wound care.All authors: Henshaw RM, Maheshwari AV, Walters JADigital Object Identifier:

http://dx.doi.org/10.3113/FAI.2012.0430

Date added to catalog: 2013-09-17

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article		Available		22735287

Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: We describe an extensile posterior approach to the ankle with detachment of the Achilles tendon for resection of extensive tumors involving the posterior ankle. To the best of our knowledge, this approach and its results have not been reported for oncologic indications.

CONCLUSION: Excellent exposure, tumor control and patient function were achieved by this approach in a select group of patients. The surgical technique described in this report offers another alternative for an extensile posterior approach to the ankle and/or subtalar joints.

METHODS: The surgical technique involved detachment of the Achilles tendon, tumor resection and reconstruction of the Achilles tendon with anchor sutures, and was used in six patients. The diagnosis was pigmented villonodular synovitis (5) and chondroblastoma (1).

RESULTS: At a mean of 6 (range, 2 to 10) years followup, all patients were free from tumor. All patients could walk an unlimited amount without any support. There were no problems with Achilles incompetence. The mean Musculoskeletal Tumor Society score was 97 +/- 4.2% (range, 90 to 100) and the mean Achilles Tendon Total Rupture Score was 95 +/- 5.7 (range, 87 to 100). One patient with screwed suture anchors had backing out of two anchors along with deep infection, requiring surgical debridement and anchor removal. One other patient had a post-traumatic small wound dehiscence which responded to local wound care.

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