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A report of three cases which required tibialis anterior tendon resection to recover delayed wound healing after total ankle arthroplasty in patients with rheumatoid arthritis
- Source :
- Modern rheumatology case reports. 4(1)
- Publication Year :
- 2020
-
Abstract
- Delayed wound healing is one of the severe complications after total ankle arthroplasty (TAA). In particular, once tibialis anterior (TA) tendon is exposed from tendon sheath of extensor retinaculum, wound healing will be critically intractable. We report three cases (mean age: 75.3 years old) of delayed wound healing after TAA cured by resection of TA tendon in patients with rheumatoid arthritis (RA). All three cases underwent TAA through an anterior approach, with careful suture of extensor retinaculum in wound closure. Ankle joint was fixed with splint and avoid weight bearing for three weeks after surgery. Delayed wound healing with TA tendon exposure was observed, and initially treated by debridement, basic fibroblast growth factor spray, and negative pressure wound therapy, which all failed to obtain wound healing. Finally, complete resection of TA tendon led to rapid wound healing. In all cases, ankle dorsal flexion was compensated by other extensors, with maintained range of motion and muscle strength (manual muscle testing 3 to 4) compared to pre-operation at 1 year after TAA operation. Resection of TA tendon may be considered as one of the salvage treatment options of severe delayed wound healing in TAA with anterior approach, especially in elderly patients.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Arthritis, Rheumatoid
Tendons
Retinaculum
Arthroplasty, Replacement, Ankle
Suture (anatomy)
Negative-pressure wound therapy
medicine
Humans
Muscle Strength
Range of Motion, Articular
Aged
Wound Healing
integumentary system
Tibia
business.industry
musculoskeletal system
Tendon
Surgery
Tendon sheath
medicine.anatomical_structure
Treatment Outcome
Ankle
business
Wound healing
Range of motion
Ankle Joint
Subjects
Details
- ISSN :
- 24725625
- Volume :
- 4
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Modern rheumatology case reports
- Accession number :
- edsair.doi.dedup.....e8beab8fccfaf9ff1d3dd31c8e8708e9