What is the term/name used for ta lengthening procedure or per cutaneous method
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percutaneous Achilles tendon lengthening procedure name TA lengthening technique
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Hoke procedure triple hemisection percutaneous TAL tendoachilles lengthening eponym
Here is a complete answer on the percutaneous TA (Tendo Achilles) lengthening procedure:
Percutaneous TA Lengthening - Names and Terminology
The percutaneous Achilles tendon lengthening procedure goes by several names:
Primary Eponym: Hoke Procedure
- Formally called the "Percutaneous Triple Hemisection" or "Triple Hemi-section Tendo Achilles Lengthening (TAL)"
- The technique itself was described by Hatt and Lamphier in 1947 and is attributed to Hoke, so it is widely known as the Hoke Procedure
- The historical origin of percutaneous Achilles lengthening dates to Hibbs in 1914, who first described it for equinus contracture
Common Names Used Interchangeably:
| Term | Meaning |
|---|---|
| PTAL | Percutaneous Tendo Achilles Lengthening |
| TAL | Tendo Achilles Lengthening (general abbreviation) |
| Hoke Procedure | Eponym for the triple hemisection technique |
| Triple Hemisection | Descriptive name - three stab incisions, each cutting half the tendon |
| Percutaneous Triple Hemi-section | Full descriptive name |
What the Procedure Involves:
- Three small stab incisions are made along the Achilles tendon
- At each incision, half the tendon is cut (hence "hemi-section"):
- Proximal incision: medial half cut
- Middle incision: lateral half cut
- Distal incision: medial half cut (near calcaneal insertion)
- Gentle dorsiflexion force allows the cut fibers to slide, lengthening the tendon while preserving overall continuity
Indications:
- Equinus contracture (toe-walking, foot drop)
- Spastic equinus (cerebral palsy)
- Diabetic forefoot ulcers with equinus
- Clubfoot (as part of correction)
As confirmed by Miller's Review of Orthopaedics and Campbell's Operative Orthopaedics: "Equinus deformity is addressed with either an open Z-lengthening of the Achilles tendon or a percutaneous triple hemisection technique."
In short - "Hoke procedure" is the most widely used eponym, and "PTAL" or "TAL" are the common abbreviations for this percutaneous method.
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