A review of salvage procedures after failed Achilles tendon repair.

The most common complications that are associated with delayed repair of the Achilles tendon are rerupture, wound necrosis, infection, and inability to regain dorsiflexion. Wound complications can be avoided by using meticulous soft-tissue handling techniques, full-thickness flaps when necessary, and minimal pressure to the wound postoperatively. Ankle stiffness may be reduced by ensuring that the repair does not place undue tension on the tendon which requires the ankle to be placed in excessive plantarflexion. Good restoration of function can be obtained by surgical intervention. Regardless of the size of the defect, etiology, or delay in treatment, the salvage procedures described can successfully restore strength and function. It is imperative, however, that patients take an active role in their rehabilitation and remain motivated throughout their course of postoperative therapy.