title: The percutaneous surgical approach for repairing acute Achilles tendon rupture: a comprehensive outcome assessment.
abstract: BACKGROUND
  Treatment modalities for acute Achilles tendon rupture can be divided into operative and nonoperative. The main concern with nonoperative treatment is the high incidence of repeated ruptures; operative treatment is associated with risk of infection, sural nerve injury, and wound-healing sequelae. We assessed our experience with a percutaneous operative approach for treating acute Achilles tendon rupture.
  
  
  METHODS
  The outcomes of percutaneous surgery in 29 patients (25 men; age range, 24-58 years) who underwent percutaneous surgery for Achilles tendon rupture between 1997 and 2004 were retrospectively evaluated. Their demographic data, subjective and objective evaluation findings, and isokinetic evaluation results were retrieved, and they were assessed with the modified Boyden score and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale.
  
  
  RESULTS
  All 29 patients demonstrated good functional outcome, with no- to mild-limitations in recreational activities and high patient satisfaction. Mean follow-up was 31.8 months. Changes in ankle range of motion in the operated leg were minimal. Strength and power testing revealed a significant difference at 90 degrees /sec for plantarflexion power between the injured and healthy legs but no difference at 30 degrees and 240 degrees /sec or in dorsiflexion. The mean modified Boyden score was 74.3, and the mean Ankle-Hindfoot Scale score was 94.5.
  
  
  CONCLUSIONS
  Percutaneous surgery for Achilles tendon rupture is easily executed and has excellent functional results and low complication rates. It is an appealing alternative to either nonoperative or open surgery treatments.
authors.affiliation: Department of Orthopedic Surgery, Sheba Medical Center, Tel-Hashomer, Israel. shayten@gmail.com
authors.forename: Shay
authors.initials: S
authors.lastname: Tenenbaum
authors.forename: Niv
authors.initials: N
authors.lastname: Dreiangel
authors.forename: Ayal
authors.initials: A
authors.lastname: Segal
authors.forename: Amir
authors.initials: A
authors.lastname: Herman
authors.forename: Amnon
authors.initials: A
authors.lastname: Israeli
authors.forename: Ahron
authors.initials: A
authors.lastname: Chechik
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D000843:Ankle Joint / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery; D016896:Treatment Outcome