The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment.
BACKGROUND
There is still controversy regarding the optimal surgical technique and post-operative treatment of acute Achilles tendon ruptures. We evaluated a treatment protocol for Achilles tendon ruptures consisting of a minimally invasive Achilles tendon repair combined with early full weight bearing.


METHODS
A consecutive group of 163 patients was prospectively followed during a 6 year period (1998-2004) in one university hospital and five teaching hospitals. Data were collected during the outpatient department visits at 1, 3, 5, and 7 weeks, 4 months and 12 months after the intervention. Outcome parameters were the incidence of re-rupture, other complications, the functional outcome and the period of sick leave concerning work and sport.


RESULTS
The patient group consisted of 128 men (79%) and 35 women (21%). The mean operating time was 41 min. In 9 patients (5.5%) a major complication occurred, necessitating 5 surgical re-interventions (2 for re-ruptures, 2 for infections and 1 for tendon necrosis). Fifteen patients (9.2%) suffered from dysfunction of the sural nerve. The median time of returning to work was 28 days (range 1-368) and the median time of returning to sport was 167 days (range 31-489). The majority of patients (150; 92%) were satisfied with the results.


CONCLUSIONS
Minimally invasive Achilles tendon repair in combination with a functional rehabilitation program is a safe and quick procedure with a low rate of re-rupture and a high level of patient satisfaction.
Lansdaal
J R
JR
Trauma Unit Department of Surgery, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
Goslings
J C
JC
Reichart
M
M
Govaert
G A M
GA
van Scherpenzeel
K M
KM
Haverlag
R
R
Ponsen
K J
KJ
D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D053580:Muscle Strength; D017060:Patient Satisfaction; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery