title: Percutaneous repair of the ruptured tendo Achillis.
abstract: Percutaneous repair of the ruptured tendo Achillis has a low rate of failure and negligible complications with the wound, but the sural nerve may be damaged. We describe a new technique which minimises the risk of injury to this nerve. The repair is carried out using three midline stab incisions over the posterior aspect of the tendon. A No. 1 nylon suture on a 90 mm cutting needle approximates the tendon with two box stitches. The procedure can be carried out under local anaesthesia. We reviewed 27 patients who had a percutaneous repair at a median interval of 35 months after the injury. They returned to work at four weeks and to sport at 16. One developed a minor wound infection and another complex regional pain syndrome type II. There were no injuries to the sural nerve or late reruptures. This technique is simple to undertake and has a low rate of complications.
authors.affiliation: Southmead Hospital, Bristol, England.
authors.forename: J M
authors.initials: JM
authors.lastname: Webb
authors.forename: G C
authors.initials: GC
authors.lastname: Bannister
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000772:Anesthesia, Local; D000843:Ankle Joint / Q000503:physiopathology; D001265:Athletic Injuries / Q000601:surgery*; D002370:Casts, Surgical; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques