title: Surgical treatment of Achilles tendon ruptures: the comparison of open and percutaneous methods in a rabbit model.
abstract: BACKGROUND
  This study was intended to investigate the healing properties of open and percutaneous techniques in a rabbit model and compare histological, electron microscopical, and biomechanical findings of the healed tendon between the groups.
  
  
  METHODS
  Twenty-six rabbits were randomly assigned to two groups of thirteen rabbits each. Percutaneous tenotomy of the Achilles tendon (AT) was applied through a stab incision on the right side 1.5 cm above the calcaneal insertion in all animals. Using the same Bunnell suture, the first group was repaired with the open and the second group was repaired with the percutaneous method. ATs were harvested at the end of eight weeks for biomechanical and histological evaluation.
  
  
  RESULTS
  When the sections were evaluated for fibrillar density under electron microscopy, it was noted that fibrils were more abundant in the percutaneous repair group. The tendon scores in the percutaneous group were less than the open group indicating closer histological morphology to normal. The difference was not significant (p=0.065). The mean force to rupture the tendon was 143.7± 9.5 N in percutaneous group and 139.2±8.2 N in the open group. The difference was not significant (p=0.33).
  
  
  CONCLUSIONS
  Percutaneous techniques provide as good clinical results as the open techniques do. The healing tendon shows better findings in histological and electron microscopical level with percutaneous technique.
authors.affiliation: Department of Orthopaedics and Traumatology, Selcuk University Faculty of Medicine, Konya, Turkey. aflguney@hotmail.com.
authors.forename: Güney
authors.initials: G
authors.lastname: Yılmaz
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mahmut Nedim
authors.initials: MN
authors.lastname: Doral
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Egemen
authors.initials: E
authors.lastname: Turhan
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Gürhan
authors.initials: G
authors.lastname: Dönmez
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ahmet Özgür
authors.initials: AÖ
authors.lastname: Atay
authors.affiliation: Department of Sports Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Defne
authors.initials: D
authors.lastname: Kaya
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000818:Animals; D023421:Models, Animal; D011817:Rabbits; D011897:Random Allocation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D014945:Wound Healing