A safe percutaneous repair of Achilles tendon rupture

Abstract

Background Although percutaneous repair of Achilles tendon rupture avoids possible complications of open repair as well as conservative treatment, sural nerve injury and re-rupture are the potential complications of percutaneous technique. Here, we describe a surgical technique to minimize the risk of sural nerve injury. Patients and methods This study included 22 patients with complete Achilles tendon rupture treated using the presented percutaneous technique within a mean of 8.5 days (2–28 days) of injury. There were 18 men and four women, with a mean age of 34.7 years (25–48 years). Clinical examination, ankle plain radiograph, and Achilles tendon MRI were done for all patients. All patients were followed up for a mean of 26 months (18–40 months). Results For 22 patients over the period of follow-up, the mean American Orthopedic Foot and Ankle Society Score was 92.81 (82–100). MRI showed satisfactory healing of the Achilles tendon in all patients at 3 months. All patients had a nearly full range of ankle movement recovery at the latest follow-up. The mean time interval from repair to return to work was 7.54 weeks. There was neither sural nerve injury nor re-rupture observed during the follow-up period. Conclusion The presented percutaneous technique is easy and safe, with a low rate of complications. This technique avoids the possible complications of conservative management and open surgery with neither re-rupture nor sural nerve injury, as the percutaneous sutures are not placed in the lateral half of the Achilles tendon proximal to rupture site.