Complications of Achilles and posterior tibial tendon surgeries

Surgery of the Achilles and posterior tibial tendons requires finesse to ac hieve optimal function. Although superficial in anatomic location, various critical neurovascular structures exist in close proximity. The superficial blood supply is fragile, requiring a delicate touch to prevent problems wi th wound healing. Damaged tendon tissue often is friable, making it difficu lt to sew or anchor. Adjusting the tendon length to the appropriate tension requires good judgment and affects long-term outcome through power and ran ge of motion. Finally, surgery on these two tendons significantly affects f unction of the ankle and longitudinal arch, where small changes are magnifi ed into large changes in maintaining normal gait. The current authors revie w the complications encountered in various common surgeries of the Achilles and posterior tibial tenons.