title: Conservative, open or percutaneous repair for acute rupture of the Achilles tendon.
abstract: OBJECTIVE
  To review the complications and recovery of patients with Achilles tendon rupture managed by percutaneous repair, open repair, and non-operative means in a tertiary referral centre between 2001 and 2003.
  
  
  METHODS
  The operating theatre register and logbooks of the Consultants were used to identify surgically managed patients, while plaster room records were used for conservatively managed patients. We collated demographic and management details.
  
  
  RESULTS
  The number of plaster changes (p < 0.001), median length of time in cast (p < 0.001), and number of outpatient visits (p < 0.05) was greater in conservatively managed patients. We performed no formal statistical analysis given the small numbers. Conservative management was the least expensive and open surgery the most costly modality of management. Percutaneous surgery was approximately a third of the cost of open surgery when performed under local anaesthetic.
  
  
  CONCLUSIONS
  In our setting, percutaneous repair and conservative management are viable alternatives to open surgery, which carries higher complications rates and was the most costly of the three. Individual patients will have different needs due to their age, occupation, or level of sporting activity.
authors.affiliation: Department of Postgraduate Medicine, University of Keele, Stoke-on-Trent, UK.
authors.forename: Ananthan Dave
authors.initials: AD
authors.lastname: Ebinesan
authors.forename: Bhupinder Singh
authors.initials: BS
authors.lastname: Sarai
authors.forename: Gayle D
authors.initials: GD
authors.lastname: Walley
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000208:Acute Disease; D000328:Adult; D002370:Casts, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D011183:Postoperative Complications; D012189:Retrospective Studies; D012421:Rupture / Q000191:economics / Q000628:therapy