title: [REPAIR OF ACUTE CLOSED ACHILLES TENDON RUPTURES BY CHANNEL-ASSISTED MINIMALLY INVASIVE REPAIR SYSTEM].
abstract: OBJECTIVE
  To evaluate the effectiveness of channel-assisted minimally invasive repair (CAMIR) for acute closed Achilles tendon ruptures.
  
  
  METHODS
  Between January 2011 and June 2012, 30 patients (30 sides) with acute closed Achilles tendon ruptures were treated with CAMIR technique. Among 30 patients, 18 were male and 12 were female with an average age of 30.4 years (range, 22-50 years); the locations were left side in 10 cases and right side in 20 cases. All the causes were sports injury. B-ultrasound was used to confirm the diagnosis, with the average distance from the rupture site to the Achilles tendon insertion of 4.4 cm (range, 2-8 cm). The time from injury to operation was 3 hours to 9 days (median, 4 days). All injuries were repaired by CAMIR technique.
  
  
  RESULTS
  The average operation time was 17.0 minutes (range, 10-25 minutes), and the mean incision length was 2.0 cm (range, 1.5-2.5 cm). All the incisions healed by first intention. There was no complication of wound problem, deep vein thrombosis, re-rupture, or sural nerve injury. All cases were followed up 12-24 months with an average of 16 months. At last follow-up, the patients could walk normally with powerful raising heels and restored to normal activity level. MRI imaging suggested the continuity and healing of ruptured tendon. The circumference difference between affected leg and normal leg was less than 1 cm, and the ankle dorsi-extension was 20-30°, plantar flexion was 20-30°. Arner Lindholm score showed that the surgical results were excellent in 28 cases and good in 2 cases, with an excellent and good rate of 100%.
  
  
  CONCLUSIONS
  CAMIR is a safe and reliable method to repair acute closed Achilles tendon rupture, with many advantages of minimal injury, low re-rupture and infection. Sural nerve injury can be minimized using CAMIR by carefully placing the suture channel with a stab incision and special trocar based on a modified Bunnel suture technique.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.forename: Ming
authors.initials: M
authors.lastname: Hao
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.forename: Xiangdang
authors.initials: X
authors.lastname: Liang
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhang
authors.forename: Yizhu
authors.initials: Y
authors.lastname: Guo
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000208:Acute Disease; D000843:Ankle Joint; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012421:Rupture / Q000601:surgery; D013497:Sural Nerve; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D020196:Trauma, Nervous System; D014945:Wound Healing