Treatment of acute and closed Achilles tendon ruptures by minimally invasive tenocutaneous suturing.

ABSTRACT

Achilles tendon rupture is a common injury, and its complications can impair function. Numerous operations have been described for reconstructing the ruptured tendon, but these methods can compromise the microcirculation in the tendon and can seriously damage healing of the tendon. Suturing with a minimally invasive tenocutaneous technique soon after the rupture and systematic functional exercise can greatly reduce the possibility of complications. From June 1996 to February 2007, we treated 20 patients (14 males), who ranged in age from 21 to 66 years old, with this method. After follow-up period of 1 to 7 years, the mean American Orthopedic Foot and Ankle Society Ankle Hindfoot score was 95 (range 90 to 98), and the maximum length of postoperative scarring was 3 cm. One patient again ruptured his Achilles tendon 1 year after surgery in an accident; however, after 10 months, the repaired tendon was still intact. In another patient, the nervus suralis was damaged during surgery by piercing the tension suture at the near end, causing postoperative numbness and swelling. The tension suture was quickly removed, and the patient recovered well with conservative treatment. No large irregular scars, such as those sustained during immobilization, were present over the Achilles tendon. Minimally invasive percutaneous suturing can restore the original length and continuity of the Achilles tendon, is minimally invasive, and results in fewer postoperative complications than other methods.