Percutaneous suturing of the ruptured Achilles tendon under local anesthesia.
A prospective study of modified percutaneous Achilles tendon repair performed from 1991 to 1997 under local anesthesia with a minimum 2-year follow-up is presented. There were 134 procedures in 124 men and 8 women (mean age, 37 years) treated within 7 days after acute total rupture. Postoperative care consisted of wearing a cast or soft-cast immobilization for 6 weeks. The procedure was well tolerated in all patients. There was 1 (0.7%) complete and 4 (3%) partial reruptures. Six patients (4.5%) developed transient sural neuritis that spontaneously resolved in 3 to 10 months. One case of deep venous thrombosis was successfully treated. There were no cases of increased postoperative dorsiflexion, deep infection, or necrosis. Eighteen patients (14%) had a slightly decreased range of ankle motion; 129 (98%) patients, including all high-caliber athletes, resumed all their previous activities, 22 of them (17%) with some minor complaints. The mean American Orthopedic Foot and Ankle Society's ankle-hindfoot score was 96 points. The proposed method offers a reasonable treatment option for acute total Achilles tendon ruptures, with a low number of complications and a low risk of sural nerve injury. The rerupture rate and return to preinjury activities is comparable to open procedures.
Cretnik
Andrej
A
Department of Traumatology, Teaching Hospital Maribor, Maribor, Slovenia. andrej.cretnik@guest.arnes.si
Kosanović
Milos
M
Smrkolj
Vladimir
V
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012421:Rupture; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery