title: Minimally invasive versus open surgery for acute Achilles tendon rupture: a systematic review.
abstract: BACKGROUND
  This review provides a comprehensive description of clinical, functional outcomes, and complications after open and minimally invasive surgery for Achilles tendon ruptures.
  
  
  METHODS
  We systematically searched Medline (PubMED), EMBASE, CINHAL, Cochrane, Sports Discus and Google scholar databases using the combined keywords 'open repair', 'percutaneous surgery', 'minimally invasive surgery' 'Achilles tendon rupture', 'complications', 'infections', 'wound disorders' to identify articles published in English, Spanish, French and Italian.
  
  
  RESULTS
  Twelve studies fulfilled our inclusion criteria. Six studies were retrospective, five were randomized controlled trials and one was a prospective investigation. Of a total of 781 patients, 375 underwent open repair and 406 percutaneous surgery. Different procedures were performed for open and minimally invasive repair.
  
  
  RESULTS
  The range of motion was significantly greater after percutaneous repair than open surgery. The number of complications that occurred after open surgery was higher than after minimally invasive surgery.
  
  
  CONCLUSIONS
  Minimally invasive surgery is less expensive and less time demanding.
  
  
  CONCLUSIONS
  Minimally invasive and open surgery of the Achilles tendon are grossly equivalent. However, iatrogenic neurological complications are more frequent after percutaneous repair. Novel percutaneous repairs have been proposed to minimize the risk of sural nerve injury.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Del Buono
authors.forename: Andrea
authors.initials: A
authors.lastname: Volpin
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012421:Rupture
keywords: Achilles tendon rupture; minimally invasive surgery; open repair surgery