Kuleva O. Transposition of muscle with Achilles damage tendons

Actuality of theme. Damage to the Achilles tendon (AS) is an actual problem of modern traumatology and orthopedics, which occurs mainly in patients of working age from 30 to 45 years. The frequency of this pathology is about 18 cases per 100,000 population per year (Costa M. L. et al., 2006). At the same time, in recent years there seems to be a tendency to increase the frequency of AU discontinuities in the population, which is due to the increase in the number of people engaged in sports from time to time in a sedentary way of life in general (Lantto I. et al., 2015). The aim of the study. To substantiate the use of muscular tendon transpositions in patients with Achilles tendon damage on the basis of improvement of clinical and instrumental diagnostics and anatomical substantiation of transposition. Object of research: Achilles tendon in norm and at break. Subject of research: ultrasonic and biochemical changes in the trigeminal muscle of the calf during the breakdown of the Achilles tendon, transposition of muscles in the surgical treatment of lesions of the Achilles tendon. Scientific novelty. The Achilles tendon displacement amplitude was first investigated in the Thompson test with a curved and bent shin, and a significant (p <0.01) increase in excursion was observed when performing a Thompson test with a curved shin depending on the growth of the m.soleus thickness. The dynamics of collagen content in the tissues of the trigeminal muscle of the calf during the subcutaneous rupture of the Achilles tendon was investigated for the first time, namely in the proximal region of the tendon itself and the distal region of the spatum muscle, which topographically represent the zone of muscular tendon transition; The low collagen content (<4x) in the tendon tissue is shown in relation to the norm and its further significant decrease (R2 = - 0.44, p <0.01) in the follow-up dynamics during 160 days after the discontinuity. For the first time, the echogenicity of the flaky muscle was investigated at the damage of the Achilles tendon and it was found that the increase in echo density in fresh cases is not due to an increase in the content of collagen, which does not differ significantly from the norm (p> 0.05). For the first time, the choice of donor muscles for transposition during restoration operations on the Achilles tendon is anatomically grounded, the possibility of a reliable overlapping of the potential donor muscles of most of the Achilles tendon and the advantage of the small thymus muscles is proved.