Achilles Tendon Lengthening refers mostly to a surgical procedure whereby the tendon is stretched to allow a child or adult to walk flat-footed without a bend in the knee or to relieve chronic pain. The procedure is designed to lengthen a tendon that has not formed properly or has been injured. There are several methods of lengthening the Achilles tendons, with the most mild being physical therapy and/or a brace, and the most aggressive being surgery.
There are three main types of surgery for Achilles tendon lengthening. The first is called a Gastrocnemius recession, and is used only for very mild cases. This procedure targets only the gastrocnemius muscle and attempts to loosen the muscle fibers that are attached to the tendon.
The second type of Achilles tendon lengthening is called percutaneous tendon lengthening, where a surgeon will make several cuts in the tendon. The human body can repair these tears naturally with the production of more muscle tissue, which will add overall length to the tendon. This type of surgery does not allow the surgeon to have much control over the degree of lengthening.
The third and most common type of Achilles tendon lengthening is called z-plasty lengthening. In this case, a surgeon makes a z-shaped cut in the tendon, stretches it to a pre-specified length, and then sutures the tendon back together. This procedure allows the greatest control over the length and enlargement.
Recovery time for these surgeries is usually four to six weeks in some kind of walking cast, during which time there is limited mobility and aggressive physical therapy to allow the tendon to heal properly. If symptoms are mild, surgery may not be worth the risks. Sometimes, however, chronic pain can last a lifetime and a relatively quick and easy surgical procedure could alleviate this discomfort.
Problems with the Achilles tendon can be caused by a number of factors, including genetics, injury and birth defects. When the Achilles tendon is too short, the foot stays in a bent position, with a flat foot forcing the knee to bend or else a person endures considerable pain. Other symptoms might be abnormal toe positions, frequent discomfort in the back of the foot, and poor posture. Muscle spasticity can also be corrected using Achilles tendon lengthening.
Whereas ligaments connect bone to bone, a tendon connects muscle to bone. The strongest tendon in the body is the Achilles tendon, named after a warrior in Greek mythology. The Achilles tendon contracts when necessary to move the bones that allow people to walk, jump, run or stand on their toes.