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Abstract
Very distal tears of the Achilles tendon are uncommon, and poor quality tendinous
tissue of the calcaneal stump can compromise healing. Little has been published about
the characteristics and surgical management of such injuries. We present a surgical
technique, developed by the senior author, to restore continuity of the gastrosoleus-Achilles
tendon-calcaneus complex using a free ipsilateral semitendinosus graft, and clinical
outcomes of a case series of 28 consecutive patients. Our hypothesis was that this
is a safe technique, and patients can return to pre-injury occupation and athletic
activities.