title: Achilles tendon repair, a modified technique.
abstract: BACKGROUND
  Wound complications following open repair for acute Achilles tendon ruptures (AATR) remain the subject of significant debate. The aim of this study is to investigate the effects of covering repaired AATR using well-nourished connective tissues (paratenon and deep fascia) to avoid complications after open repair.
  
  
  METHODS
  In this case series study, open repair was performed for 32 active young patients with AATR. After the tendon was repaired, the deep fascia and paratenon was used to cover the Achilles tendon. Patients were followed for two years and any wound complication was recorded. During the last visit, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score was completed for all patients. Calf circumference and ankle range of motion were measured and compared with the contralateral side. Patients were asked about returning to previous sports activities and limitations with footwear.
  
  
  RESULTS
  Only, one patient developed deep wound infection (3%). None of the patients had any discomfort around the operation area, limitation with footwear, sural nerve injury, re-rupture, and skin adhesion. The AOFAS score averaged 92.5±6. Two patients (7%) were unable to return to previous sports activities because of moderate pain in heavy physical exercises. The calf circumference and ankle ROM were similar between healthy and operated sides.
  
  
  CONCLUSIONS
  The present study showed that fascial envelope for full covering of the repaired Achilles tendon may help to prevent the occurrence of wound complications.
authors.affiliation: Sohrab Keyhani MD, Department of Orthopedic Surgery, Akhtar Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Keyhani
authors.affiliation: Sohrab Keyhani MD, Department of Orthopedic Surgery, Akhtar Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Mardani-Kivi
authors.affiliation: Sohrab Keyhani MD, Department of Orthopedic Surgery, Akhtar Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Abbasian
authors.affiliation: Sohrab Keyhani MD, Department of Orthopedic Surgery, Akhtar Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emami-Moghaddam Tehrani
authors.affiliation: Sohrab Keyhani MD, Department of Orthopedic Surgery, Akhtar Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Farivar Abdollahzadeh
authors.initials: FA
authors.lastname: Lahiji
keywords: Achilles tendon; Open repair; Wound complication