Surgical treatment of achilles tendon rupture: examination of strength of 3 types of suture techniques in a cadaver model.
BACKGROUND
The mechanical properties of present-day percutaneous repairs of Achilles tendon ruptures are not known.


METHODS
Artificially-created ruptures in 24 human cadaveric Achilles tendons were repaired with an open Bunnell repair, a percutaneous calcaneal tunnel or a percutaneous bone-anchor repair. In the open technique no.1 PDS-II absorbable suture material was used, and in the percutaneous techniques either no.1 PDS-II or no.1 Panacryl absorbable suture material was used. The specimens were tested in a materials testing machine until failure occurred.


RESULTS
The common mode of failure was suture breakage in non-anchor repairs, and anchor pullout in anchor repairs. The average strength of the repairs varied from 166 N (SD 60) to 211 N (SD 30), with no differences between the techniques (p = 0.5).


CONCLUSIONS
Taking costs into account, the percutaneous calcaneal tunnel technique and the open technique are the methods of choice.
Zandbergen
Robbert A
RA
Departments of Orthopedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
de Boer
Stefan F
SF
Swierstra
Bart A
BA
Day
Judd
J
Kleinrensink
Gert-Jan
GJ
Beumer
Annechien
A
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D002102:Cadaver; D006801:Humans; D008422:Materials Testing; D019651:Plastic Surgery Procedures / Q000379:methods*; D012421:Rupture; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength; D016896:Treatment Outcome