{"text":"\\ \ne v = O} O \" _ \n[ \nB \nGLASGOW ROYAL INFIRMARY , \u2019 | \nMrKumar m\\m\\t\\m\\\\\\\\mm\\\\\\\\wmw \n10338654% \u00a5 \nigi\u2018;m 08\/09\/1955 \n39 RENNIE ROAD \nZ\ufb01g . @65 9PQ \nDATE | 01\/05\/2013 LRSS0 5528 \nNo. 05230 \nOPERATION \nSECONDARY REPAIR OF ACHILLES TENDON AND FHL TRANSFER LEFT ANKLE \nName: Mrs Agnes Clelland \u2019 Ward: 62, \n39 Rennie Road-Kilsyth Glasgow Lanarkshire G65 9PQ Surgeon: Mr Senthil Kumar \nHospital No: 10338654X D.O.B.: 08\/09\/1955 Assistant: Mr Sam Roberts \nIndication: \ufb01_(;t}ltl)les Tendon Mrdsubstance Rupture Anaesthetist: Dr Shiona Stott \nANAESTHETiC: SPINAL AND POPLITEAL BLOCK(SS) | : - \nDVT prophylaxis: Aspiri\ufb01 150mg for 6 weeks- MEDIUM RISK \nAntibiotic prophylaxis: 1.5g ce_furoxime iv \nPOSITION AND TOURNIQUET: Prone position. Thigh tourniquet. \nAPPROACH: Longitudinal midline incision, complete rupture with extensive scarring noted. Proximal retracted \nby 7-8cm, dissected upto the musculotendinous junction. Turn-down flap of medial third of the gastrocnemius \ntendon, sutured to the distal stump. FHL divided just distal to the fibrous tunnel and plugged into a drill hole over \nthe back of the os calcis iri front of the Achilles tendon, held with a Biotenodesis screw. FHL muscle belly sutured \nonto\u2019the tendon. \nCLOSURE: 2,0 vicryl to the subcutaneous layers, with skin closure with clips. No drain was used. Below knee \nplaster in full equinus applied. - \nPOST \u2014 OPERATIVE INSTRUCTIONS: \nRoutine observations CSM. \nMobilise when comfortable, partial weight-bearing. . \nFollowup: Nurse-led clinic 10 days for change of plaster, - \nIMAINATAIN FULL EQUINUS. \n\u2018See in Mr. Kumar\u2019s cI_mlc 4-6 weeks thereafter. \nMATERIAL SENT FOR EXAMINATION . - \/ \nSigned: . ' : C. S. 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