The percutaneous suture of the Achilles tendon with the Dresden instrument.
OBJECTIVE
Minimally invasive suture of the torn Achilles tendon without opening the rupture site, reduction in the risk of a sural nerve lesion, and optimization of stump apposition.


METHODS
Fresh Achilles tendon rupture.


METHODS
Chronic achillodynia, local corticoid injections, immunosuppressive therapy, old Achilles tendon ruptures, rerupture.


METHODS
Suture of the Achilles tendon with a special instrument via a skin incision proximal to the rupture, without opening the peritenon or the rupture site, whereby the suture in the area of the proximal Achilles tendon is placed in the layer between the lower-leg fascia and the peritenon with the threads running in a paratendinous direction.


RESULTS
From January 1, 2000 to December 31, 2003, 61 patients with 62 Achilles tendon ruptures were sutured using the percutaneous technique with the Dresden Instrument. No sural nerve lesions and only two reruptures (3.2%) were observed. In one patient (1.6%) a superficial late infection occurred after 8 weeks, when the tendon was already healed. Of 47 patients with a follow-up time of at least 1 year, 39 with 40 Achilles tendon ruptures were followed up (83%). According to the criteria of Trillat & Mounier-Kuhn, the result was very good in 62% and good in 30%. On the AOFAS Score, an average of 96 points (78-100 points) was achieved. 78% of the patients assessed the result of the treatment as very good and 20% as good.
Amlang
Michael H
MH
Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus Technische Universität Dresden. Michael.Amlang@uniklinikum-dresden.de
Christiani
Paula
P
Heinz
Peter
P
Zwipp
Hans
H
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011182:Postoperative Care; D011183:Postoperative Complications; D011300:Preoperative Care; D012008:Recurrence; D012421:Rupture; D013525:Surgical Instruments; D013536:Suture Techniques / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome