firemedic1’s AchillesBlog

If anyone was curious as to what exactly is done during an ATR repair I’ve transcribed the procedure notes for anyone to take a look at.  It is not to be implied that if you decide to have operative ATR repair that this will be exactly what happens but it’s just a general overview of what to expect.

PROCEDURE DATE: 06/06/2016

SURGEON: XXXXXXXXX

ASSISTANT: XXXXXXXXX

PREPROCEDURAL DIAGNOSIS: Achilles tendon rupture, Left

POSTPROCEDURE DIAGNOSIS: Achilles tendon rupture, Left

PROCEDURE PERFORMED: Achilles tendon repair, Left

ANESTHESIA: General

ESTIMATED BLOOD LOSS: Less than 25 ml

TOURNIQUET TIME: 40 minutes

BRIEF CLINICAL HISTORY:
Patient suffering a Left Achilles tendon rupture.  Patient was seen and noted to have a gap and the tendon edges were not able to be approximated.  We had discussed nonoperative functional bracing versus operative management and given the risks and benefits of both, patient wished to proceed with operative management.

DESCRIPTION OF PROCEDURE:
Patient was seen in preop holding area.   Proper site of surgery was marked.  Patient was taken to the operating room, positioned supine.  General anesthesia was administered.  A nonsterile carefully padded tourniquet was placed onto the Left upper thigh and the patient was then placed in the Left lateral decubitus position with all pressure points padded including an axillary roll.  The leg was prepped and draped in usual sterile fashion.  Leg was exsanguinated and the tourniquet inflated to 290 mmHg.  A medial approach to the Achilles tendon was performed.  Paratenon was opened.  The tendon was completely ruptured.  Both edges were cleaned up so the frayed edges were minimized and number 2 Tycron was used in a modified Krackow stitch.  A 4 core suture repair was performed.  The same procedure was done on the distal segment.  Once the 2 segments were prepared, the foot was plantar flexed to a neutral position, and the sutures were tied completely.  A running 3-0 Monocryl was used for an epitendinous stitch.  The paratenon was then repaired using a 3-0 Monocryl, the skin with an interrupted 3-0 nylon.  20 cc of 0.25 percent plain Marcaine were infiltrated in wound edges.  Sterile dressings were applied.  A splint in equinus was applied and the patient was brought to the PACU in stable condition.  I was present for all portions.

XXXXXXXX, CNP was utilized given the complexity of the case, need for skilled mobilization and retraction.

End report.

This entry was posted on Wednesday, June 22nd, 2016 at 09:12 and is filed under In the beginning.... You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.