J Korean Foot Ankle Soc.  2018 Jun;22(2):68-73. 10.14193/jkfas.2018.22.2.68.

Comparative Study of Clinical Outcome of Three Surgical Techniques in the Achilles Tendon Rupture: Open Repair, Percutaneous Repair, and Minimal Incision Repair by Achillon

Affiliations
  • 1Department of Orthopaedic Surgery, Dong-A University Hospital, Busan, Korea. tynitus@dau.ac.kr
  • 2Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea.

Abstract

PURPOSE
This study compared the clinical outcomes of open repair, percutaneous repair, and minimal incision repair by Achillon in ruptured Achilles tendon.
MATERIALS AND METHODS
The outcomes of 12 patients with open repair (group 1), 8 patients with percutaneous repair (group 2), and 10 patients with minimal incision repair by Achillon (group 3) from February 2013 to March 2016 were analyzed retrospectively. The postoperative clinical evaluations were done by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Arner-Linholm scale, mid-calf circumference difference, one-leg heel raise difference, visual analogue scale (VAS) for postoperative scarring, time to return to work, and complications.
RESULTS
No significant difference in the AOFAS ankle-hindfoot score, Arner-Linholm scale, and time to return to work was observed among three groups (p=0.968, 0.509, and 0.585). The mean differences in the mid-calf circumference in groups 1, 2, and 3 were 1.09, 0.73, and 0.58, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.002). In addition, the mean VAS scores for postoperative scarring in groups 1, 2, and 3 were 7.0, 9.1, and 9.1, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.001). The mean differences in one-leg heel raising in groups 1, 2, and 3 were 2.03, 1.91, and 1.33, respectively; group 3 was significantly higher than groups 1 and 2 (p=0.010). The complications encountered were one case of deep infection in group 1 and one case of sural nerve hypoesthesia in group 2.
CONCLUSION
Minimal incision repair by Achillon is recommended as an effective surgical treatment for Achilles tendon rupture because it minimizes the risk of complications, leads to an improved tendon strength and healing, and achieves cosmetic satisfaction.

Keyword

Achilles tendon; Rupture; Open repair; Percutaneous repair; Achillon

MeSH Terms

Achilles Tendon*
Ankle
Cicatrix
Foot
Heel
Humans
Hypesthesia
Retrospective Studies
Return to Work
Rupture*
Sural Nerve
Tendons

Figure

  • Figure 1 Intraoperative photograph that open repair (A) using 2-0 Ethibond by Krackow's suture technique (B).

  • Figure 2 (A) Preoperative marking of incision was made over the area of the rupture confirmed by ultrasonography in percutaneous repair. (B) Suture configuration of Carmont & Maffulli procedure.

  • Figure 3 (A) Minimal incision Achilles tendon repair by the Achillon was introduced proximal Achilles tendon stump. (B) The same procedure was performed on the distal stump. (C) Ruptured Achilles tendon was repaired by indirect suture technique by 3 separate sutures.


Cited by  1 articles

Minimal Invasive Surgery for Acute Achilles Tendon Rupture
Myoung Jin Lee, Min-Woo Kim
J Korean Foot Ankle Soc. 2021;25(2):76-79.    doi: 10.14193/jkfas.2021.25.2.76.


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