title: Treatment of acute and closed Achilles tendon ruptures by minimally invasive tenocutaneous suturing.
abstract: BACKGROUND
  Achilles tendon rupture is a common injury, and its complications can impair function. Numerous operations have been described for reconstructing the ruptured tendon, but these methods can compromise microcirculation in the tendon and can seriously impair its healing. Suturing with a minimally invasive tenocutaneous technique soon after the rupture and systematic functional exercise can greatly reduce the possibility of complications.
  
  
  METHODS
  Between June 1996 and February 2009, we treated 88 patients (54 males; age range, 21-66 years) with this method.
  
  
  RESULTS
  After follow-up ranging from 1-7 years, the mean American Orthopedic Foot and Ankle Society ankle-hind foot score was 95 (range, 90-98), and the maximum length of postoperative scarring was 3 cm. One patient re-ruptured his Achilles tendon one year after surgery in an accident, but after 10 months, the repaired tendon was still intact. In another patient, the nervus suralis was damaged during surgery by piercing the tension suture at the near end, causing postoperative numbness and swelling. The tension suture was quickly removed, and the patient recovered well with conservative treatment. No large irregular scars, such as those sustained during immobilization, were present over the Achilles tendon.
  
  
  CONCLUSIONS
  Minimally invasive percutaneous suturing can restore the original length and continuity of the Achilles tendon, is minimally invasive, and has fewer postoperative complications than other methods.
authors.affiliation: Department of Orthopaedic Surgery, 3rd Affiliated Hospital of Suzhou University, People's Republic of China.
authors.forename: Wenge
authors.initials: W
authors.lastname: Ding
authors.forename: Weihong
authors.initials: W
authors.lastname: Yan
authors.forename: Yaping
authors.initials: Y
authors.lastname: Zhu
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D012421:Rupture / Q000145:classification / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000145:classification / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult