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Achilles Tendon Lengthening is an orthopedic surgical procedure performed to lengthen a tight or shortened Achilles tendon located at the back of the ankle. The Achilles tendon connects the calf muscles to the heel bone and plays an important role in walking, running, standing, and foot movement.
When the Achilles tendon becomes too tight, it can restrict ankle movement and cause the foot to point downward. This condition is known as equinus deformity. It may develop due to congenital conditions, neurological disorders, cerebral palsy, clubfoot, muscle tightness, or long-term changes in muscle and tendon function.
The main goal of Achilles Tendon Lengthening is to improve ankle flexibility, correct abnormal foot positioning, reduce muscle tightness, and restore better walking ability.
Before surgery, doctors perform a detailed physical examination to assess ankle movement, tendon flexibility, muscle strength, and walking patterns. Additional tests, such as X-rays or other imaging examinations, may be recommended depending on the patient's condition.
During the procedure, the patient is given appropriate anesthesia. The orthopedic surgeon makes small incisions near the Achilles tendon and carefully lengthens it using a selected surgical technique. This allows the ankle to move more naturally and helps the foot achieve a better position.
Percutaneous Tendon Lengthening: Uses small cuts in the tendon to gradually increase its length.
Open Tendon Lengthening: Uses a surgical incision to expose and lengthen the tendon directly.
Z-Plasty Lengthening: Uses a Z-shaped surgical technique to lengthen the tendon while maintaining continuity.
Gastrocnemius Recession: Releases or lengthens the gastrocnemius muscle to improve ankle movement while preserving the deeper soleus muscle.
Reduces tightness in the Achilles tendon.
Improves ankle flexibility and movement.
Helps correct equinus foot deformity.
Improves walking and standing ability.
Reduces abnormal pressure on the front of the foot.
Helps improve foot positioning in patients with clubfoot or cerebral palsy.
Supports better mobility and physical function.
Recovery after Achilles Tendon Lengthening depends on the surgical technique, the patient's age, and the severity of tendon tightness.
After surgery, the ankle is generally supported with a plaster cast, splint, or walking boot to protect the healing tendon. Patients may need to avoid putting weight on the affected foot for a specific period, depending on the surgeon's instructions.
Physiotherapy is an important part of recovery. Gentle stretching, strengthening exercises, and gradual walking activities help restore ankle movement and muscle function. Regular follow-up appointments allow doctors to monitor tendon healing and prevent complications.
Infection or bleeding.
Swelling and temporary pain.
Tendon weakness.
Over-lengthening of the tendon.
Reduced push-off strength while walking.
Nerve or blood vessel injury.
Tendon shortening or recurrence of tightness.
Some patients may require additional physiotherapy, ankle braces, orthotic footwear, or rehabilitation exercises to maintain proper foot positioning and improve mobility. Regular orthopedic examinations help evaluate long-term results.
Achilles Tendon Lengthening is an important orthopedic treatment for patients experiencing restricted ankle movement due to a tight or shortened Achilles tendon. Proper diagnosis, careful surgical planning, physiotherapy, and regular follow-up care help improve ankle flexibility and walking function.
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