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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
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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: markglazebr@hotmail.com.

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Techniques in Foot & Ankle Surgery includes CME-certified content that is designed to meet the educational needs of its readers. This activity is available for credit through February 28, 2021.

Earn CME credit by completing a quiz about this article. You may read the article here, on the TFAS website, or in the TFAS iPad app, and then complete the quiz, answering at least 80 percent of the questions correctly to earn CME credit. The cost of the CME exam is $10. The payment covers processing and certificate fees. If you wish to submit the test by mail, send the completed quiz with a check or money order for the $10.00 processing fee to the Lippincott CME Institute, Inc., Wolters Kluwer Health, Two Commerce Square, 2001 Market Street, 3rd Floor, Philadelphia, PA 19103. Only the first entry will be considered for credit, and must be postmarked by the expiration date. Answer sheets will be graded and certificates will be mailed to each participant within 6 to 8 weeks of participation.

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Credit Designation Statement

Lippincott Continuing Medical Education Institute, Inc., designates this journal-based CME activity for a maximum of 1 (one) AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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