Limited incision with sponge forceps assisted threading in treatment of acute closed rupture of Achilles tendon

Abstract

Objective To explore the clinical advantages of limited incision with sponge forceps assisted threading in the treatment of acute closed rupture of achilles tendon.Methods From August 2011 to December 2013,97 cases of acute closed achilles tendon rupture were treated by limited incision with sponge forceps assisted threading.They were 69 men and 28 women,16 to 66 years of age (35.6 years).The left side was injured in 60 cases and the right side in 37 cases.Time from injury to surgery was from 1 to 7 days,averaging 3.2 days.One 2 to 3 cm long incision was made about 1 cm medial to the medial edge of the achilles tendon at the rupture site.With a pair of sponge forceps,suture lines were threaded through the tendon and tied to suture the ruptured tendon.Results The patients were followed up until 6 months postoperatively.The operation time ranged from 37 to 50 minutes,with an average of 43.2 minutes.Local incision exudation occurred in 4 cases which responded to daily dressing change.One patient had superficial wound infection which was cured by debridement and wound suture.The incisions of the other 92 cases healed primarily and their stitches were taken out after 3 weeks.Re-ruptures occurred in 4 cases within 6 months postoperation which were treated by end-to-end anastomosis in re-operation.No sural nerve irritation was observed in this cohort.The American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores at 6 months postoperation averaged 92.Conclusion Limited incision with sponge forceps assisted threading is a practical technique for treatment of acute closed rupture of achilles tendon,because it is minimally invasive and simple,and leads to fewer complications and quicker recovery. Key words: Achilles tendon; Ankle injuries; Surgical procedures, minimally invasive