Avoiding sural nerve injuries during percutaneous Achilles tendon repair.
BACKGROUND
Sural nerve injury is a reported risk during percutaneous repair of the Achilles tendon.


OBJECTIVE
Exposure of the sural nerve during percutaneous repair can minimize the risk of nerve injury.


METHODS
Case control study; Level of evidence, 3.


METHODS
The authors retrospectively examined the results of 84 patients who were treated for acute Achilles tendon rupture at 2 different hospitals. Both hospitals used the same percutaneous repair technique, except that the sural nerve was exposed in the 38 patients (mean age, 38 years; range, 23-68 years) of one hospital; the nerve was not exposed in the 46 patients (mean age, 42 years; range, 24-71 years) of the other hospital (the nonexposure group).


RESULTS
All patients recovered and returned to work after 44 days (range, 5-202 days). All patients returned to their previous sports levels within 1 year. On the 100-point Hannover Achilles Tendon Score, the mean score was 81 points (range, 44-100 points). The overall incidence of sural nerve related complications was 18%. All sural nerve lesions occurred in the nonexposure group. In the total study population, there were 3 cases of deep vein thrombosis, 1 rerupture, and 1 case of infection.


CONCLUSIONS
Sural nerve injuries can be minimized during surgery by carefully placing the stab incisions to expose the nerve so as to avoid it during repair. If the sural nerve is exposed, percutaneous repair of the ruptured Achilles tendon is a safe and reliable method of treating Achilles tendon ruptures.
Majewski
Martin
M
Department of Orthopaedic Surgery, Kantonsspital Liestal, Rheinstrasse 26, CH-4410 Liestal, Switzerland. majewski01@yahoo.de
Rohrbach
Markus
M
Czaja
Stephan
S
Ochsner
Peter
P
D000125:Achilles Tendon / Q000601:surgery*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012421:Rupture / Q000517:prevention & control; D013497:Sural Nerve / Q000293:injuries*; D013536:Suture Techniques; D020196:Trauma, Nervous System / Q000517:prevention & control