Achilles tendon rupture vestigial muscle is harvested and wrapped around the Achilles tendon, increasing the strength of the repaired tendon. If the tissue quality is poor, e.g. the injury has been neglected, the surgeon might use a reinforcement mesh (collagen, Artelon or other degradable material). In percutaneous surgery, the surgeon makes several small incisions, rather than one large incision, and sews the tendon back together through the incision(s). Surgery may be delayed for about a week after the rupture to let the swelling go down. For sedentary patients and those who have vasculopathy or risks for poor healing, percutaneous surgical repair may be
Central tendon of diaphragm Central tendon of diaphragm The central tendon of the diaphragm is a thin but strong aponeurosis situated slightly anterior to the vault formed by the muscle, resulting in longer posterior muscle fibers. It is inferior to the fibrous pericardium, which fuses with the central tendon of the diaphragm via the pericardiacophrenic ligament. The caval opening (at the level of the T8 vertebra) passes through the central tendon. This transmits the inferior vena cava and right phrenic nerve. It is shaped somewhat like a trefoil leaf, consisting of three divisions or leaflets separated from one another by slight indentations. The right