I picked up a copy of the Operative Report at my pre-op appointment last week. I was curious to read more about the technique used to shorten my tendon. The surgeon briefly described the procedure prior to the surgery, but sensing my confusion, he admitted it would be easier if he had a picture. I scoured the internet in the weeks leading up to the surgery to find out more information on Achilles shortening surgeries, but found very little. I believe the image below, one of the few I found, best illustrates the procedure my surgeon used.
The procedure is referred to as a z-shortening or z-plasty. I believe the technique is actually used more for lengthening procedures, but apparently it works for shortening as well. Basically, a short horizontal cut is made from the edge of the tendon towards the center. The cut then turns vertically along the center of the tendon. A second horizontal cut is made from the center towards the other edge. The pattern of the cut resembles a “Z”, hence the name. A small section of each end of the tendon is then removed and the ends are slid along the vertical plane until the proper tension is achieved. Once the tension is set the tendon is sutured together with fiber wire. Seems pretty simple.
I’ve set up a page that includes the operative report. You can click on the link at the top of the site, or click HERE to read more details about the procedure.
You can also click HERE for an article that has a few more images of the z-shortening procedure. Just click on the “Full Text” link on the right side of the page. The pictures are about midway through the article. Beware, a few images are a bit graphic.
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