[A comparative study on repair of acute Achilles tendon rupture using three operating techniques].
OBJECTIVE
To compare the effectiveness of the 3 methods (traditional open Achilles tendon anastomosis, minimally invasive percutaneous Achilles tendon anastomosis, and Achilles tendon anastomosis limited incision) for acute Achilles tendon rupture so as to provide a reference for the choice of clinical treatment plans.


METHODS
Between December 2007 and March 2010, 69 cases of acute Achilles tendon rupture were treated by traditional open Achilles tendon anastomosis (traditional group, n=23), by minimally invasive percutaneous Achilles tendon anastomosis (minimally invasive group, n=23), and by Achilles tendon anastomosis limited incision (limited incision group, n=23). There was no significant difference in gender, age, mechanism of injury, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score between 3 groups (P > 0.05).


RESULTS
Minimally invasive group and limited incision group were significantly better than traditional group in hospitalization days and blood loss (P < 0.01). Incision infection occurred in 2 cases of traditional group, and healing of incision by first intention was achieved in all patients of the other 2 groups, showing significant difference in the complication rate (P < 0.05). Re-rupture of Achilles tendon occurred in 1 case (4.3%) of minimally invasive group and limited incision group respectively; no re-rupture was found in traditional group (0), showing significant difference when compared with the other 2 groups (P < 0.05). All cases were followed up 12-18 months with an average of 14.9 months. The function of the joint was restored. The AOFAS score was more than 90 points in 3 groups at 12 months after operation, showing no significant difference among 3 groups (P > 0.05).


CONCLUSIONS
The above 3 procedures can be used to treat acute Achilles tendon rupture. However, minimally invasive percutaneous Achilles tendon anastomosis and Achilles tendon anastomosis limited incision have the advantages of less invasion, good healing, short hospitalization days, and less postoperative complication, and have the disadvantage of increased risk for re-rupture of Achilles tendon after operations.
Department of Orthopaedics, Shanghai Changzheng Hospital, PR China.
Ting
T
Wang
Guohua
G
Mei
Zhongmin
Z
Shi
Yimin
Y
Chai
Changqing
C
Zhang
Chunlin
C
Hou
D000125:Achilles Tendon / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D000714:Anastomosis, Surgical; D000843:Ankle Joint; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery; D013530:Surgical Wound Infection; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing