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Botulinum toxin improves reduced dorsiflexion after Achilles tendon surgery

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Generally, outcome after surgical repair of complete Achilles tendon rupture is good. However, some patients have ongoing problems with dorsiflexion of the ankle joint. We report on eight patients, who did not achieve heel contact because of reduced ankle dorsiflexion 5 months after surgical repair of complete Achilles tendon rupture. All patients received at least three cycles of injections with 200–300 units of Botulinum toxin A (BOTOX®) into the gastrocnemius and soleus muscle. Weakening of the triceps surae by Botulinum toxin allowed patients to perform the required exercises and to tolerate casting at night. Thus, all patients were able to tolerate plantigrade foot position 9 months after beginning of Botulinum toxin treatment. At final follow-up after 2 years, pain had significantly improved, and a mean dorsiflexion of 21° was reached. In conclusion, treatment of the calf muscles with BOTOX® is a safe and effective method to improve restricted dorsiflexion in patients after Achilles tendon repair.

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Acknowledgments

There was no funding or grant for the project provided from any source. Dr. Iris Reuter, Dr. Olaf Lorbach, Dr. Sabine Mehnert, Professor M. Kaps and Dr. Martin Engelhardt did not receive any financial benefits related to the cases reported. Dr. Martin Engelhardt, Dr. Olaf Lorbach and Professor Dr. Manfred Kaps have never received any grants from PharmAllergan or any other Botulinum toxin producing company. Dr. Iris Reuter has received educational grants from PharmAllergan, Ipsen and Merz in the past for projects not related to the case reports. Dr. Sabine Mehnert has received educational grants from PharmAllergan, Ipsen and Merz in the past for projects not related to the case reports. The case reports have not been presented at a conference or reported elsewhere.

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Authors and Affiliations

  1. Department of Neurology, Justus-Liebig-University Giessen, Am Steg 14, 35392, Giessen, Germany

    Iris Reuter, Sabine Mehnert & Manfred Kaps

  2. Department of Orthopedic and Trauma Surgery, Klinikum Osnabrück, Am Finkenhügel 1, 49076, Osnabrück, Germany

    Olaf Lorbach & Martin Engelhardt

Authors
  1. Iris Reuter
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  2. Olaf Lorbach
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  3. Sabine Mehnert
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  4. Manfred Kaps
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  5. Martin Engelhardt
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Correspondence to Iris Reuter.

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Reuter, I., Lorbach, O., Mehnert, S. et al. Botulinum toxin improves reduced dorsiflexion after Achilles tendon surgery. Knee Surg Sports Traumatol Arthrosc 18, 265–268 (2010). https://doi.org/10.1007/s00167-009-0948-0

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  • DOI: https://doi.org/10.1007/s00167-009-0948-0

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