title: Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study.
abstract: BACKGROUND
  Controversy regarding the optimal treatment of the fresh total Achilles tendon rupture remains.
  
  
  OBJECTIVE
  To compare the results of percutaneous and open Achilles tendon repair.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  The results of 132 consecutive patients with acute complete Achilles tendon rupture who were operated on exclusively with modified percutaneous repair under local anesthesia from 1991 to 1997 and followed up for at least 2 years were compared to the results of 105 consecutive patients who were operated on exclusively with open repair under general or spinal anesthesia in the same period.
  
  
  RESULTS
  There were significantly fewer major complications in the group of percutaneous repairs in comparison with the group of open repairs (4.5% vs 12.4%; P = .03), particularly necrosis (0% vs 5.6%; P = .019), and a lower total number of complications (9.7% vs 21%; P = .013). There were slightly more reruptures (3.7% vs 2.8%; P = .680) and sural nerve disturbances (4.5% vs 2.8%; P = .487) in the group of percutaneous repairs, with no statistically significant difference. Functional assessment using the American Orthopaedic Foot and Ankle Society scale and the Holz score showed no statistically significant difference.
  
  
  CONCLUSIONS
  The results of the study support the choice of (modified) percutaneous suturing under local anesthesia as the method that brings comparable functional results to open repair, with a significantly lower rate of complications.
authors.affiliation: Department of Traumatology, Teaching Hospital Maribor, Ljubljanska 5, 2000 Maribor, Slovenia. andrej.cretnik@guest.arnes.si
authors.forename: Andrej
authors.initials: A
authors.lastname: Cretnik
authors.forename: Milos
authors.initials: M
authors.lastname: Kosanovic
authors.forename: Vladimir
authors.initials: V
authors.lastname: Smrkolj
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D012421:Rupture; D013536:Suture Techniques; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome