title: [Percutaneus Suture of Achilles Tendon Rupture--Operation for Beginners?].
abstract: BACKGROUND
  Acute rupture of the Achilles tendon is the most common tendon injury, with an incidence of 30/100,000 population. With the Dresden instruments, operative tendon suture can be standardised and is safe, quick and minimally invasive. With post-operative functional therapy in a walking boot, very good clinical results can be achieved.
  
  
  OBJECTIVE
  Is this operation suitable as an educational procedure and is its performance still economic?
  
  
  METHODS
  Between 1 January 2007 and 31 December 2013, 212 patients with acute rupture of the Achilles tendon were operated using the Dresden instruments. There were 167 males and 45 females, with an average age of 46 years. 99 operations were performed by trainees, 46 by attending surgical staff, and 57 by a senior surgeon.
  
  
  RESULTS
  With the trainees, the mean duration of the operation was 29:53 minutes, and with the attending staff 29:10 minutes (n. s., p > 0.1). The rate of complications (re-rupture, infection, and sural nerve damage) was 5/99 (5 %) for the trainees, 4/46 (8.7 %) for the attending staff, and 3/57 (5.3 %) for the senior surgeon. A total cost analysis yielded a total operative cost of 445.76 € for outpatient surgery. With a billed sum of 490.11 €, net income of 44.35 € per case is generated. In patients with reasonable indications for 2-day short inpatient treatment, total treatment cost was 3232.70 €.
  
  
  CONCLUSIONS
  Percutaneous suture of the Achilles tendon with the Dresden instruments is a standardised and cost-effective surgical procedure. It is suitable as a "beginner's" procedure that can be performed quickly, safely, and cost-effectively.
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Kliniken Sindelfingen, Klinikverbund Südwest.
authors.forename: A
authors.initials: A
authors.lastname: Prokop
authors.affiliation: Medizincontrolling, Klinikverbund Südwest, Sindelfingen.
authors.forename: R
authors.initials: R
authors.lastname: Dolezych
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Kliniken Sindelfingen, Klinikverbund Südwest.
authors.forename: M
authors.initials: M
authors.lastname: Chmielnicki
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D002983:Clinical Competence; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012421:Rupture / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D053441:Suture Anchors / Q000191:economics* / Q000706:statistics & numerical data; D013536:Suture Techniques / Q000191:economics* / Q000295:instrumentation; D016896:Treatment Outcome