Chronic Rupture of the Calcaneal Tendon in a Bitch - Treatment with Autologous Fascia Lata Graft Associated with Polypropylene Mesh
DOI:
https://doi.org/10.22456/1679-9216.140434Keywords:
arthrodesis, ligament injury, orthopedic, reconstructionAbstract
Background: Treatment of Achilles tendon ruptures, especially when there is significant loss of length, presents a complex surgical challenge in both human and veterinary medicine. Various techniques have been employed to repair these injuries, including reconstruction with an autologous fascia lata graft, which offers advantages over synthetic materials and yields excellent outcomes for partial or complete tendon defects. This study details the case of a bitch Yorkshire Terrier which presented with plantigrade support on the left pelvic limb six months prior, following a skin laceration in the caudal region of the tibia caused by an accident involving a knitting machine at a pet shop.
Case: A 1-year-and-4-month-old bitch Yorkshire Terrier, weighing approximately 1.35 kg, presented with plantigrade support on the left pelvic limb 6 months ago, following a skin laceration in the caudal region of the tibia caused by an accident with a knitting machine in a pet shop. Despite initial treatment with dermorrhaphy and anti-inflammatory medication by a colleague, permanent postural changes persisted. Clinical examination revealed normal parameters for the species, with orthopedic evaluation indicating grade II/III lameness of the left pelvic limb, postural changes associated with the distal gastrocnemius muscle, and rupture of the common Achilles tendon, along with fibrous tissue attached to the distal end of the gastrocnemius muscle. Surgical reconstruction was performed with an autologous fascia lata graft, polypropylene mesh, and temporary pantarsal arthrodesis to prevent permanent tibiotarsal arthrodesis. The dog showed full weight bearing on the operated limb 10 days postoperatively and was discharged from the hospital with satisfactory limb support at 50 days, following removal of the transarticular fixation and recommendation to use an orthosis until bone consolidation.
Discussion: The presented case describes a traumatic rupture of the Achilles tendon in a bitch, resulting from an accident during a grooming procedure in a pet shop. The chronicity of the injury, diagnosed 6 months after the incident, complicated treatment. Clinical signs, including lameness and postural changes, were consistent with the literature. Radiography confirmed the injury and ruled out an avulsion fracture. Surgical repair was performed with an autologous fascia lata graft, reinforced with polypropylene mesh, and immobilization of the tarsus for 30 days. The combination of these techniques resulted in a satisfactory recovery, even in the face of the chronicity of the injury and significant tissue loss. Clinical examination revealed normal parameters for the species, with orthopedic evaluation indicating grade II/III lameness of the left pelvic limb, postural changes associated with the distal gastrocnemius muscle, and rupture of the common Achilles tendon, along with fibrous tissue attached to the distal end of the gastrocnemius muscle. Radiographic evaluation of the tibia, fibula, and tibiotarsal joint revealed thickening of the distal end of the gastrocnemius muscle and the region of insertion of the common calcaneal tendon into the calcaneal tuber. Based on orthopedic and radiographic findings, the patient was diagnosed with traumatic rupture of the calcaneal tendon, without evidence of avulsion injury to the tendon insertion, and underwent surgical reconstruction with an autologous fascia lata graft, polypropylene mesh, and temporary pantarsal arthrodesis to prevent permanent tibiotarsal arthrodesis. Ten days postoperatively, the dog showed full weight bearing on the operated limb and was discharged with satisfactory limb support 50 days after removal of the transarticular fixation, with a recommendation to use an orthosis until bone consolidation.
Keywords: arthrodesis, ligament injury, orthopedic, reconstruction.
Título: Ruptura crônica do tendão calcanear em uma cadela - tratamento com enxerto autólogo de fáscia lata associado com malha de polipropileno.
Descritores: cirurgia veterinária, ortopedia veterinária, traumatologia.
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