Case Reports

Combined posterior and anterior ankle arthroscopy arthrodesis with triple hemisection Achilles tendon lengthening in equinus ankle contracture: a case report

I Made Yudi Mahardika , Francis Celeste, Hendry Suhendra, Langga Sintong

I Made Yudi Mahardika
General Practitioner Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia. Email: yudi_mahardika_92@yahoo.com

Francis Celeste
General Practitioner Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia

Hendry Suhendra
Orthopaedic Surgeon, Department of Orthopedic Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia

Langga Sintong
Orthopaedic Surgeon, Department of Orthopedic Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
Online First: September 30, 2020 | Cite this Article
Mahardika, I., Celeste, F., Suhendra, H., Sintong, L. 2020. Combined posterior and anterior ankle arthroscopy arthrodesis with triple hemisection Achilles tendon lengthening in equinus ankle contracture: a case report. Indonesia Journal of Biomedical Science 14(2): 66-69. DOI:10.15562/ijbs.v14i2.236


Background: Arthroscopic surgery has been one of the fastest-growing surgical treatments of choice in orthopedics in the last decade. Ankle arthroscopy is an established treatment of choice for most ankle pathologies. It has generally been performed with the use of anterior portals with the patient in the supine position. Only a few articles have been published on ankle arthroscopy performed using posterior portals, particularly with the patient in the prone position. Various arthroscopy techniques have been successfully applied to the treatment of various ankle pathologies, including equinus ankle contracture.

Case presentation: A 34-year-old female patient presented with an equinus gait 2 years prior to the consultation. This occurred after open reduction with internal fixation (ORIF) of her left proximal tibia fracture. After the surgery, the patient had chronic osteomyelitis complications and deep peroneal palsy (drop foot). The patient had four previous surgeries of debridement of the tibia until the infection healed. As the deep peroneal palsy was left untreated, the patient developed an equinus ankle contracture. Achilles tendon lengthening with triple hemisection was planned with combined posterior and anterior ankle arthroscopic arthrodesis procedure. This included the release of the tibiotalar and subtalar capsule, along with arthrodesis of the ankle with 2 cannulated screws.

Conclusion: Triple hemisection Achilles tendon lengthening with combined posterior and anterior ankle arthroscopy arthrodesis is an effective treatment modality in equinus ankle contracture cases. Arthroscopy is beneficial as it minimally invasive, with less surgical duration time and is associated with faster recovery and less postoperative infections.

 

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