Featuring Dr. Alastair Younger, MB, Ch.B, M.Sc, Ch.M, F.R.C.S.(C), Orthopaedic Foot and Ankle Surgeon

Duration: 2 minutes, 53 seconds

People can rupture their tendons after playing a sport or if they have a fall. And some people are at risk of rupturing tendons because tendons all degenerate as we get older.

The common ones are broken around the ankle area is the Achilles tendon which is the common one that everyone knows about, the heel cord. On occasion, the Achilles tendon can be repaired right away.

For people who want to mobilize quickly or for people who may have walked on it before the diagnosis was made and the ends of the tendon have come apart. In those cases, we fix the tendon by taking stitches and holding one end of the tendon onto the other so that it heals at the correct length, because it’s very important to make sure the tendons are at the right length so that the muscles that fire around those tendons can do their job.

These operations can also be done later if the tendon rupture is missed for a long time or that somebody says that they don’t want surgery at the initial presentation. And these can be fixed again, using similar techniques with the acute repair, but instead we need to take other tendons to reinforce the repair so that it works and that everything is held at the right length.

Tendon operations are often difficult to do and they often lead to problems with wound healing, so there’s a number of techniques being developed to reduce the amount of skin incision or skin opening that’s required to get to the tendon to repair it.

But, because of the concerns about wound healing around the heel cord in particular, a lot of the times surgeons feel that the risk of repairing tendons either early or late might result in a wound
breakdown that can be very difficult to treat.

So these tendon ruptures can be complex. They’re much harder to fix later than earlier and the results get worse in time because the muscles get de-conditioned and it’s harder to make them work if you leave it a long time.

So there’s a number of ways that tendons have surgery and this may be either because
of problems right away or problems later because the tendon healed too long.

So if you think that your tendons are not working properly and something needs to be done about
it, it may be a good idea to talk to your family doctor and see if you can be sent on to
somebody who can look after that problem for you and potentially shorten the tendons or
repair them right away if this is something that’s occurred very recently - within one to two
weeks.

Presenter: Dr. Alastair Younger, Orthopaedic Surgeon, Vancouver, BC

Local Practitioners: Orthopaedic Surgeon