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Asymmetric Z-Tendon Shortening to Maximize Excision of Abnormal Tendon Tissue

A Technique Tip to Treat Elongated Tendons With Pathology

Stathakis, Alexander, BSc*; Wadden, Cai, MD, FRCS(C); Glazebrook, Mark, MSc, PhD, Dip Sports Med, MD, FRCS(C)

Techniques in Foot & Ankle Surgery: March 2019 - Volume 18 - Issue 1 - p 43–47
doi: 10.1097/BTF.0000000000000218
CME Article

Operative treatment for a diseased or elongated Achilles tendon often involves resection of diseased tissue and Achilles tendon shortening. If the amount of diseased tissue is minimal, a traditional Z-shortening technique can be used to achieve appropriate tendon repair and function, which involves making an incision along the longitudinal axis mid-substance of the Achilles tendon. This technique is limited in its ability to resect abnormal tissue due to the placement of the incision traditionally along the midline of the tendon. In this chapter we describe an original modification of the Z-shortening technique to allow for the flexibility to resect pathologic tendon tissue and preserve more normal tissue.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.

*Medical Student, Department of Medicine

Assistant Professor of Surgery, Department of Surgery

Professor of Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada

M.G. provides Research/institutional support and is a Consultant/employee for Smith & Nephew, Wright Inc., Ferring Inc., and Cartiva Inc. He also serves as a Journal reviewer for Foot & Ankle International, JBJS(A), The Bone & Joint Journal, and CORR; and is one among the Board of Directors for COA and AOFAS. The remaining authors declare no conflict of interest.

Address correspondence and reprint requests to Mark Glazebrook, MSc, PhD, Dip Sports Med, MD, FRCS(C), Room 4867, Halifax Infirmary, QEII Health Sciences Centre, 1796 Summer Street, Halifax, NS, Canada B3H 3A6. E-mail:


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