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Percutaneous Tendo Achillis Lengthening to Promote Healing of Diabetic Plantar Foot Ulceration

Amanda Willrich, DPM ^*, Arush K. Angirasa, DPM ^* and Ronald A. Sage, DPM ^*  

^* Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL.
Podiatry Section, Loyola University Medical Center, Maywood, IL.
Hines Veterans Affairs Hospital, Hines, IL.

Corresponding author: Ronald A. Sage, DPM, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1st Ave, Bldg 105, Ste 1700, Maywood, IL 60152-5594.

Abstract

The etiology of ulcerations related to increased plantar pressure in patients with diabetes mellitus is complex but frequently includes a component of gastrocnemius soleus equinus. One viable treatment option is percutaneous tendo Achillis lengthening as a means of increasing dorsiflexory range of motion and decreasing forefoot shear forces. This article presents three case reports illustrating the importance of reducing plantar pressure as a crucial component of treatment of diabetic forefoot ulcerations. (J Am Podiatr Med Assoc 95(3): 281–284, 2005)