The traumatic rupture of the Achilles' tendon - an analysis of the modern methods of evaluation and treatment.

ABSTRACT

AIMS: The main aim of this article is an analysis of both advantages and disadvantages of the modern solutions of treatment - percutaneous surgery, in comparison with the classic methods of treatments described in the surgery of Achilles' tendon. PATIENTS AND METHOD: The study was conducted on 23 patients admitted to the Orthopedics and Traumatology Clinic of Cluj-Napoca between January 2011-June 2012. Nineteen (19) patients were diagnosed with a complete rupture of the Achilles tendon and 4 patients with a partial rupture. The diagnosis of traumatic Achilles tendon ruptures was usually clinical, the Ultrasound (common or 3D) and the MRI confirmed the lesion and determined its location and extension. We analyzed the diagnostic methods, the elapsed time before surgery, the treatment options depending on lesion's location, technical difficulties, costs, postoperative care, the average healing time, complications. RESULTS: The Ultrasound was performed in 65.2% of the patients (15 patients) for confirming the extension of the lesion and it served for pre-operative planning. In most of the cases, the classical methods of Achilles tendon reconstruction were used (18 cases). The complications rate was about 8%. We diagnosed an iterative Achilles tendon rupture (the patient was initially treated using the percutaneous methods) and a delay in cicatrisation. CONCLUSIONS: The percutaneous surgical techniques are a viable alternative for the acute ruptures of Achilles tendon, the classic intervention has clear indications in lesions diagnosed late, in the recurrent tendon ruptures.