Purpose
According to the literature 8% to 25% of all Achilles tendon pathologies are partial ruptures; tears could be acute or chronic. Partial ruptures of Achilles tendon are the clinical demonstration of asymmetric loading of Achilles tendon caused by its special anatomic structure. Partial tears of Achilles tendon were first described by Ljungqvista in 1968 /1/. Increased recognizability of partial ruptures of Achilles tendon is connected with the development of ultrasound (US) and MRI techniques. The purpose of the study was to assess the role of ultrasonography examination in patients with Achilles tendon pain, with surgically proved partial tendon rupture.
Methods and Materials
Partial rupture of Achilles tendon may be a result of acute injury or a consequence of repeated microinjuries.There are three bundles of Achilles tendon and force transmission direction of each bundle is different – tendon is formed by collagen fibers running from the lateral and medial head of the gastrocnemius muscle and situated deeper soleus muscle. These units, depending on the side, rotate as left- or right-handed screws (eg, left Achilles tendon rotates against clockwise).Acute partial Achilles tendon injuries occur during excessive asymmetric loading of the tendon. The injury occurs in the most loaded bundle.Ultrasonography /7-12Mhz/ of 71 Achilles tendons was reviewed retrospectively in patients with tendon pain and clinical diagnosis of partial tear of tendon – 61 men, 10 women; mean age 41y.Most Achilles ruptures are associated with sports activity – 41 patients were professesional athletes, 19 of them amateur sport actives; 11 other.All 71 patients underwent surgical treatment of partial tendon rupture. In 22 patients endoscopy of Achilles tendon bursa was performed. In active persons, especially in athletes, operative reconstruction is recommend – 49 patients underwent open surgery.Smigielski classification of partial injuries of Achilles tendon was used to describe precisely type of tear /4/.Pathological specimen were analyzed in 59 patients.