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Reparación del tendón de Aquiles

PDF Evidence Consent
Updated Sep 2026
Illustration: ankle

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

¿Por qué se ha recomendado esta operación?

El tendón de Aquiles es el fuerte cordón situado en la parte posterior del tobillo que le permite impulsarse al caminar o correr. Cuando se desgarra por completo, esta operación une nuevamente los dos extremos desgarrados. En caso de un desgarro reciente, puede recomendarse la cirugía de inmediato, sin necesidad de probar primero un tratamiento no quirúrgico. El tratamiento no quirúrgico mediante férula o bota no resulta inferior a la cirugía en cuanto a resultados a un año, por lo que analizaremos ambas opciones con usted. La reparación abierta reduce la probabilidad de que el tendón se vuelva a desgarrar, aunque aumenta el riesgo de complicaciones en la herida. El objetivo principal es lograr un tendón estable, de modo que pueda soportar peso y volver a sus actividades habituales.

Antes de la operación

En los días previos a la cirugía, siga las instrucciones de preparación que le demos. Deberá dejar de comer y beber siete horas antes de la operación. Pedimos que sea siete horas para poder adelantar su turno si la lista de cirugías avanza antes de lo previsto. Su cirujano le indicará qué medicamentos habituales debe suspender y en qué momento. Lleve una lista por escrito de todos los fármacos que toma, y organice que alguien lo lleve a casa después de la intervención. Use ropa holgada y cómoda. Para planificar la operación, pueden utilizarse estudios como radiografías, ecografías o resonancias magnéticas. Si padece otras enfermedades, es posible que necesite análisis de sangre o una consulta con el anestesista antes de la cirugía.

El día de la intervención

Llega usted a la unidad de admisiones quirúrgicas del hospital, donde se le registra y se le prepara para la cirugía. A continuación, conocerá al anestesista, el médico encargado de sedarle y de controlar su dolor. Esta operación se realiza bajo anestesia general. En ocasiones, se añade un bloqueo nervioso regional para aliviar el dolor postoperatorio; el anestesista hablará con usted al respecto ese mismo día. Posteriormente, será conducido al quirófano, donde se llevará a cabo la intervención.

Una vez finalizada la operación, despertará en la sala de recuperación. Las enfermeras permanecerán a su lado mientras la anestesia va desapareciendo. Cuando su estado sea estable, será trasladado a una sala de hospitalización o podrá volver a casa, según el tipo de procedimiento y cómo evolucione su recuperación.

Descripción del procedimiento quirúrgico

El tendón de Aquiles es el fuerte cordón situado en la parte posterior del tobillo. Cuando se desgarra, sus dos extremos se separan, como una cuerda deshilachada. Esta operación consiste en coser esos extremos nuevamente.

El cirujano realiza una pequeña incisión sobre el tendón, en la parte posterior del tobillo. En una reparación mínimamente invasiva, la incisión es más pequeña y los puntos de sutura se pasan a través de la piel abriendo poco o nada la vaina del tendón. El cirujano puede utilizar una cámara fina para comprobar que los extremos desgarrados queden correctamente unidos. Puntos de sutura resistentes salvan el espacio entre el tendón sano situado por encima y el hueso del talón por debajo, manteniendo los extremos unidos mientras cicatrizan.

Una vez unidos los extremos del tendón, se anudan los puntos de sutura y la incisión se cierra con puntos y un vendaje. Al salir del quirófano, su tobillo se mantendrá en una posición protectora para evitar cualquier tensión sobre la reparación.

En algunas reparaciones se emplea una técnica que permite cargar peso sobre el pie antes que con la reparación abierta tradicional. Su cirujano le indicará qué método se ha previsto para usted y por qué.

Después de la operación

Despertará en la sala de recuperación, con enfermeras cerca, mientras el efecto de la anestesia desaparece. Su tobillo estará cubierto con un vendaje y mantenido en una posición protectora para evitar cualquier tensión sobre la zona operada. Le administraremos analgésicos para que se sienta cómodo, y antes de que se vaya comprobaremos el flujo sanguíneo, la sensibilidad y el movimiento del pie. Durante las primeras 24 horas después de volver a casa, debería haber alguien con usted. Su equipo médico le indicará si puede irse a casa el mismo día o si debe permanecer una noche en el hospital. Durante las dos primeras semanas, no cargue peso sobre el pie, a menos que su equipo le indique lo contrario. Dejaremos el vendaje puesto durante unos 10 días; por favor, no lo retire antes de ese plazo, a menos que se lo indiquemos. Lo cambiaremos o lo retiraremos cuando venga a su consulta.

Recuperación

Durante los primeros días, el tobillo le dolerá y se hinchará. Los analgésicos ayudan a mantener el confort, y el reposo con el pie elevado contribuye a reducir la hinchazón. Es normal que aparezcan hematomas alrededor del tobillo y en el pie; estos desaparecerán con el tiempo.

Al darle el alta, el tobillo quedará en una posición protectora para evitar tensiones sobre la zona reparada. Durante las primeras dos semanas, no debe apoyar peso en el pie, a menos que su equipo médico indique lo contrario. El vendaje se dejará puesto unos 10 días y luego se cambiará o retirará durante su siguiente visita. Posteriormente, su fisioterapeuta le guiará en ejercicios suaves para el tobillo. Empezará moviendo el pie hacia abajo libremente, procurando no flexionarlo demasiado hacia arriba. A medida que cicatrice, irá cargando más peso en el pie y comenzará a caminar distancias mayores. Algunas reparaciones permiten cargar peso antes que otras; su cirujano le indicará cuál es el plan para su caso.

En el día a día, al principio necesitará ayuda con las escaleras, hacer compras y ducharse. Dormir boca arriba con el pie elevado suele ser más cómodo. Normalmente podrá volver a trabajos de oficina y a sus actividades cotidianas en cuanto su movilidad y comodidad lo permitan, y retomar progresivamente el deporte una vez que haya recuperado la fuerza y el equilibrio. Muchas personas vuelven a practicar deporte alrededor de los cuatro meses tras una reparación mínimamente invasiva.

La recuperación varía según cada persona. Su cronograma puede ser distinto, y su cirujano y fisioterapeuta le guiarán en cada etapa.

Qué puede salir mal

La mayoría de los pacientes evolucionan bien, pero en ocasiones pueden surgir problemas. Su cirujano y el equipo lo vigilarán de cerca para detectar cualquier anomalía a tiempo.

Los problemas de la herida son lo que hay que observar con mayor atención. La piel que cubre el tendón de Aquiles tiene un flujo sanguíneo escaso, por lo que la incisión puede tardar en cicatrizar o los bordes pueden separarse. Esté atento a la aparición de enrojecimiento que se extienda desde la herida, secreción o exudado, aumento del dolor o fiebre. Si nota cualquiera de estos síntomas, llame a la clínica en lugar de esperar a su próxima cita. Algunas condiciones médicas, como la diabetes y el tabaquismo, incrementan el riesgo de complicaciones en la herida; por eso hablaremos con usted sobre sus propios riesgos antes de la cirugía.

Puede producirse una infección en la herida o en las estructuras más profundas alrededor del tendón. Generalmente se manifiesta como un dolor profundo y pulsátil que no mejora con analgésicos comunes, acompañado de calor, hinchazón y enrojecimiento. También puede ir acompañada de fiebre o sensación general de malestar. Una infección profunda requiere tratamiento inmediato; por ello, comuníquese con la clínica ese mismo día o acuda a urgencias si no puede contactarnos.

Los puntos de sutura mantienen unidos los extremos del tendón mientras este cicatriza; sin embargo, el tendón puede volver a romperse antes de haber ganado suficiente resistencia. Esto suele ocurrir al hacer un empuje brusco, tropezar o caerse. Sentiría un chasquido o estallido agudo en la parte posterior del tobillo, con debilidad repentina y dificultad para impulsarse. En tal caso, comuníquese de inmediato con la clínica o acuda a urgencias.

El nervio que discurre por la parte externa del tobillo puede irritarse durante la reparación. Esto puede provocar entumecimiento, hormigueo o sensación de ardor en el lateral del pie. Comente este síntoma en su próxima revisión; si es intenso, llame antes.

Tras esta lesión y cirugía, pueden formarse coágulos sanguíneos en las venas profundas de la pantorrilla. Las señales de alerta incluyen hinchazón repentina, sensibilidad o sensación de pesadez en la pantorrilla; si el coágulo llega a los pulmones, aparecerán dificultad para respirar o dolor torácico. En caso de dificultad respiratoria o dolor en el pecho, acuda de inmediato a urgencias. Si solo hay síntomas en la pantorrilla, llame a la clínica sin demora.

En ocasiones, el tejido cicatricial puede adherir el tendón a las estructuras circundantes, generando sensación de chasquido, roce o rigidez al mover el tobillo. Mencione esto en su próxima revisión.

En la tabla de complicaciones de esta página se detallan las tasas típicas; si desea conocer los datos exactos, puede consultarla.

¿Cuándo deben llamarnos?

Llámenos de inmediato si tiene fiebre, o si el enrojecimiento, la secreción o el dolor alrededor de la herida empeoran. Llámenos sin demora si la pantorrilla se hincha, está sensible al tacto o se siente pesada. Acuda a urgencias si le cuesta respirar o tiene dolor en el pecho, si siente un chasquido o estallido repentino en el tobillo con debilidad, o si pierde la sensibilidad en el pie o no puede moverlo. Si no logra contactarnos, acuda a urgencias.

Reviewed by AI synthesis (v2) — pending human review · 9 September 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

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Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Anatomy & Pathophysiology

Bony Anatomy

  • The ankle mortise is formed by the tibial plafond, medial malleolus, and lateral malleolus [3].
  • The ankle mortise articulates with the dome of the talar body [3].
  • The talar dome is wider anteriorly and narrower posteriorly [3].
  • The ankle mortise widens 1 to 1.5 mm during motion from plantar flexion to dorsiflexion [3].
  • Medial and superior clear spaces appear wider with the foot in plantar flexion [3].
  • The distal fibula has a convex medial surface that articulates with the concave incisura fibularis of the distal lateral tibia [3].
  • The fibula rotates approximately 2 degrees within the incisura during ankle motion and ambulation [3].
  • Ankle dorsiflexion results in external rotation and proximal translation of the fibula [3].

Ligamentous Anatomy

  • The lateral ankle ligaments function as restraints to varus and inversion forces at the ankle [3].
  • The anterior talofibular ligament (ATFL) originates from the anteroinferior aspect of the lateral malleolus, 1 cm proximal to its tip, and extends to the lateral aspect of the talar neck [3].
  • The calcaneofibular ligament (CFL) extends from the tip of the lateral malleolus to the lateral aspect of the calcaneus [3].
  • The posterior talofibular ligament (PTFL) extends from the posterior lateral malleolus to the posterolateral talus [3].
  • The ATFL is the weakest ankle ligament [3].
  • The PTFL is the strongest ankle ligament [3].
  • The distal tibiofibular joint and fibula provide stability against lateral talar translation [3].
  • The deltoid ligament complex is the primary ankle stabilizer during stance [3].
  • The deep deltoid ligament extends from the apex of the medial malleolus to the medial talar body [3].
  • The deep deltoid ligament functions primarily to resist lateral talar translation and external rotation [3].
  • The posterior deep deltoid is the most important component of the deep deltoid ligament [3].
  • The superficial deltoid ligament extends from the distal medial malleolus to the navicular bone, sustentaculum tali of the calcaneus, medial talus, and spring ligament [3].
  • The superficial deltoid ligament functions primarily to resist valgus and eversion ankle forces [3].
  • The deltoid ligament consists of superficial and deep layers, with at most six bands of which only three are constant: the tibionavicular ligament, tibiospring ligament, and deep posterior tibiotalar ligament [8].
  • The tibiocalcaneal portion of the superficial deltoid ligament is the strongest component and resists eversion of the calcaneus [8].
  • The deep portion of the deltoid ligament is organized into two short, thick, discrete bands: the anterior and posterior deep tibiotalar ligaments [8].
  • The anterior and posterior deep tibiotalar ligaments are intra-articular but extrasynovial [8].
  • The deep posterior band comprises the largest band of the deltoid complex [8].
  • The deep deltoid ligament has the highest load to failure at 713.8 N ± 69.3 compared with the lateral collateral ligaments [8].
  • The dominant mode of failure for the deep deltoid ligament is an intrasubstance rupture near its talar insertion [8].
  • The failure of the superficial deltoid ligament is most commonly at its insertion on the anterior malleolus [8].
  • Valgus tilting of the talus within the mortise requires complete rupture of both the superficial and deep deltoid ligaments [8].

Neurovascular Anatomy

  • The superficial peroneal nerve penetrates the deep fascia and lies subcutaneously 8 to 10 cm proximal to the tip of the lateral malleolus, anterior to the subcutaneous border of the fibula shaft [6].
  • The deep peroneal nerve accompanies the anterior tibial artery between the tendons of the anterior tibial and extensor digitorum longus muscles, just lateral to the extensor hallucis longus tendon [6].
  • The saphenous nerve is located just medial or posterior to the saphenous vein in a slightly deeper plane, 3 to 5 cm proximal to the tip of the medial malleolus [6].

Biomechanics

  • The ankle joint is responsible for most sagittal plane motion of the foot and ankle [3].
  • Ankle plantar flexion ranges from 23 to 48 degrees [3].
  • Ankle dorsiflexion ranges from 10 to 23 degrees [3].
  • The ankle joint also contributes to inversion, eversion, and rotation [3].

Investigations

  • MRI is sensitive for detecting osteochondral lesions of the ankle, but the edema pattern frequently overestimates the severity of the injury [12, 13].
  • Linear fluid signal deep to subchondral bone on MRI indicates an unstable osteochondral lesion [12, 13].
  • MRI has a sensitivity of 92% for predicting stable versus unstable osteochondral lesions [12, 13].
  • CT scans are helpful for evaluating bony lesions, determining the integrity of subchondral bone, identifying cysts, and preoperative planning for osteochondral lesions [12, 13].
  • AP, mortise, and lateral weight-bearing ankle x-rays may not demonstrate subtle osteochondral lesions [12, 13].
  • Advanced imaging is often helpful in the diagnosis of foot and ankle injuries when combined with a thorough clinical examination [16].
  • MRI is used for the evaluation of chronic Achilles tendon ruptures [1].
  • MRI is used for the evaluation of traumatic ligamentous injuries of the ankle and foot [1].
  • MRI is used for the evaluation of musculotendinous structures of the ankle [1].
  • MRI is used for the evaluation of sports injuries involving the ankle [1].
  • MRI is used for the pre-operative evaluation of the anterior talofibular ligament in chronic ankle instability [1].
  • MRI is used for the evaluation of anterolateral soft tissue impingement of the ankle [1, 18].
  • MRI is used for the evaluation of osteochondral lesions of the talus [1].
  • MRI is used for the evaluation of posterior tibial tendon dysfunction [1].
  • MRI is used for the diagnosis of plantar plate injury with reference to intraoperative findings [1].
  • MRI is used for the evaluation of tibiofibular syndesmotic ligaments [1].
  • MRI is used for the evaluation of chronic lateral ankle instability in conjunction with stress radiography [1].
  • MRI is used for the evaluation of associations between imaging findings and symptoms in patients with chronic ankle sprain [1].
  • MRI is used for the evaluation of accuracy in diagnosing ligamentous and chondral pathology in the ankle [1].
  • MRI is used for the evaluation of peroneal tendon abnormalities on routine imaging of the foot and ankle [15].
  • MRI is used for the evaluation of entrapment neuropathies of the lower extremity, including the knee, leg, ankle, and foot [19].
  • Ultrasonography is used for the examination of the deltoid ligament in bimalleolar equivalent fractures [17].
  • Ultrasonography is used for the point-of-care diagnosis and management of superficial peroneal nerve entrapment [19].
  • MRI lacks additional diagnostic value for stability assessment of the ankle mortise in supination-external rotation-type ankle fractures [17].
  • CT imaging is used to evaluate normal tibiofibular relationships at the syndesmosis [17].
  • Preoperative computed tomography scans are used in operative planning for malleolar ankle fractures [17].
  • Radiographic evaluation of the normal distal tibiofibular syndesmosis is a standard investigative approach [17].
  • Fluoroscopy is used to assess if the syndesmosis is reduced [17].
  • Radiographic identification of primary lateral ankle structures is possible [2].
  • Gravity stress radiographs are used to assess the effect of ankle position on deltoid ligament integrity and medial clear space measurements [2].
  • Stress radiography is used in the evaluation of chronic lateral ankle instability [1].
  • The use of advanced imaging is often helpful in diagnosis when combined with a thorough clinical examination for foot and ankle disorders [16].

Treatment

Operative Technique: Lindholm Repair

  • The patient is positioned prone for the procedure [14].
  • A posterior curvilinear incision is made extending from the midcalf to the calcaneus [14].
  • The deep fascia is incised in the midline to expose the tendon rupture [14].
  • Ragged ends of the tendon are debrided [14].
  • Tendon ends are apposed using a box type of mattress suture made of heavy nonabsorbable suture material or wire [14].
  • Fine interrupted sutures are also used to appose the tendon ends [14].
  • Two flaps are fashioned from the proximal tendon and gastrocnemius aponeurosis [14].
  • Each flap is approximately 1 cm wide and 7 to 8 cm long [14].
  • The flaps are left attached at a point 3 cm proximal to the site of rupture [14].
  • Each flap is twisted 180 degrees on itself so that its smooth external surface lies next to the subcutaneous tissue [14].
  • The flaps are turned distally over the rupture [14].
  • Each flap is sutured to the distal stump of the tendon and to one another [14].
  • The flaps cover the site of rupture completely [14].
  • The wound is closed with care taken to approximate the tendon sheath over the site of repair [14].

Operative Technique: Lynn Repair

  • The tendon sheath is opened in the midline [14].
  • The foot is held in 20 degrees of plantar flexion during the repair [14].
  • The ends of the Achilles tendon are sewn together with 2-0 absorbable sutures without excising the irregular edges [14].
  • If the plantaris tendon is intact, its insertion on the calcaneus is divided [14].
  • The plantaris tendon is fanned out to form a membrane using forceps, beginning distally [14].
  • The fanned-out plantaris membrane is placed over the repair of the Achilles tendon [14].
  • The plantaris membrane is sutured in place with interrupted sutures [14].
  • When possible, the Achilles tendon is covered for 2.5 cm both proximal and distal to the repair [14].
  • If the plantaris tendon is ruptured, it is dissected free from the Achilles tendon for several centimeters [14].
  • The ruptured plantaris tendon is divided proximally using a tendon stripper [14].
  • The plantaris tendon is pulled distally into the incision and fanned out as a free graft [14].
  • The sheath of the Achilles tendon is closed as far distally as possible without tension [14].

Postoperative Care

  • Postoperative care for these repairs is the same as that used after treatment of acute rupture of the Achilles tendon [14].

References

[1] Campbell S Operative Orthopaedics 4 Volume Set. REFERENCES > FOOT AND ANKLE.

[2] Campbell S Operative Orthopaedics 4 Volume Set. REPAIR OF ACUTE RUPTURE OF LATERAL LIGAMENTS > ACUTE ANKLE LIGAMENT INJURIES, CHRONIC ANKLE INSTABILITY.

[3] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > BIOMECHANICS OF THE FOOT AND ANKLE.

[6] Campbell S Operative Orthopaedics 4 Volume Set. MULTIPLE Z-PLASTY RELEASE OF A CONGENITAL RING > ANKLE BLOCK.

[8] Orthopaedic Knowledge Update Sports Medicine 6. Ankle and Foot Injuries and Other Disorders > Ankle Sprains > Medial Ankle Injury.

[12] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > OSTEOCHONDRAL LESIONS.

[13] Miller S Review Of Orthopaedics. OSTEOCHONDRAL LESIONS.

[14] Campbell S Operative Orthopaedics 4 Volume Set. ULNAR COLLATERAL LIGAMENT REPAIR WITH AN INTERNAL BRACE > OPEN REPAIR OF ACHILLES TENDON RUPTURE—LINDHOLM.

[15] Campbell S Operative Orthopaedics 4 Volume Set. MULTIPLE Z-PLASTY RELEASE OF A CONGENITAL RING > PERONEAL TENDONS.

[16] Orthopaedic Knowledge Update Sports Medicine 6. Ankle and Foot Injuries and Other Disorders > Summary.

[17] Orthopaedic Knowledge Update Trauma. Ankle Fractures > Annotated References.

[18] Campbell S Operative Orthopaedics 4 Volume Set. ARTHROSCOPIC EXAMINATION AND DEBRIDEMENT OF THE ANKLE JOINT > IMPINGEMENT.

[19] Campbell S Operative Orthopaedics 4 Volume Set. COMBINED HAMMER TOE AND MALLET TOE DEFORMITY WITH ASSOCIATED DOUBLE CORNS > REFERENCES > TARSAL TUNNEL SYNDROME.

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1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.