DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS:
Torn left Achilles tendon.
POSTOPERATIVE DIAGNOSIS:
Torn left Achilles tendon.
OPERATION PERFORMED:
Open repair of torn left Achilles tendon.
SURGEON: John Doe, MD
ANESTHESIA: General.
OPERATIVE INDICATIONS: The patient is a healthy (XX)-year-old male, who was playing tennis and suffered a complete rupture of the Achilles tendon. He was taken to the operating room for probe and repair. Operative repair was performed with a four-core suture repair using a modified Kessler-type suture with #2 FiberWire.
BLOOD LOSS: Minimal.
COMPLICATIONS: None.
DRAINS: None.
TOURNIQUET TIME: 40 minutes.
DESCRIPTION OF OPERATION: The patient was given 2 grams of Ancef IV piggyback prior to coming back to the operating room. Once he was back, he was transferred from the OR stretcher onto the operating room table without complication. After induction of general anesthesia, an endotracheal intubation was performed. The patient was then set into the prone position with padding underneath the chest wall and pelvis as well as the knees. A well-padded tourniquet was placed on the proximal aspect of the left thigh. The entire left lower extremity was prepped and draped in the sterile fashion. A double DuraPrep scrub was performed and routine sterile draping technique was used. An Esmarch was used to exsanguinate the left lower extremity prior to inflation of the tourniquet to 275 mmHg.
A posteromedial and longitudinal incision was made along the medial edge of the Achilles tendon measuring about 3 inches. Dissection was continued down to the paratenon. The paratenon was opened in the midline. There was a complete 100% rupture of the Achilles tendon about 3 to 4 cm above the insertion site. The edges were debrided. All hematoma was removed. Copious amounts of normal saline was used for irrigation. A four-core suture repair of running interlocking type Kessler suture was done with #2 FiberWire. The ankle was held in full plantarflexion and surgical knots were used to tie down the repair. Excellent repair was achieved.
The paratenon was then closed over top with interrupted 2-0 Vicryl suture. The subcutaneous tissue was closed with interrupted and vertical 2-0 Vicryl suture. The skin was reapproximated with staples. Subcutaneous tissues were injected with 10 mL of 0.5% Marcaine with epinephrine. Dressings were placed with Xeroform, 4 x 4’s, ABD, and a well-padded short-leg cast. The cast was univalved, stabilized with a double 6-inch Ace bandage. After reversal from general anesthesia, the patient was extubated in the operating room and transferred to the recovery room in stable condition. Tourniquet was deflated after 40 minutes. He tolerated the procedure well. There were no complications.
