Insertional tendonitis is usually seen in older athletes, and surgical exposure has been described with many different approaches. Some authors advocate a longitudinal incision placed either laterally or medially, or a combination of two incisions; however, we advocate the midline longitudinal incision. Full-thickness skin flaps are created until the paratenon is identified. The paratenon layer is then freed from the superficial tissues and split longitudinally, ensuring that a good closure can be obtained. The Achilles tendon is also longitudinally split and distally dissected medially and laterally off the calcaneus, being careful not to entirely detach the tendon. At this point, any degeneration of the tendon is excised along with the retrocal-caneal bursa and the prominence of the posterior os calcis. Two resorbable suture anchors are then used to enhance reattachment of the distal part of the tendon. A 2-0 Vicryl suture is used to reapproximate the Achilles tendon side to side and a 4-0 Vicryl suture is used to close the paratenon.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.