title: Clinical comparison of the two-stranded single and four-stranded double Krackow techniques for acute Achilles tendon ruptures.
abstract: OBJECTIVE
  Several different Krackow stitch configurations have been used for acute Achilles tendon rupture repair. Although several biomechanical studies compared different Krackow stitch configurations, to our knowledge, no previous studies compared the clinical outcome of these different suture methods. Therefore, in this study, we aimed to compare the clinical outcomes and complications of the two-stranded single and four-stranded double Krackow techniques.
  
  
  METHODS
  Sixty-eight consecutive patients who underwent open repair by using the four-stranded double Krackow (33 patients, group A) or the two-stranded single Krackow (35 patients, group B) techniques between September 2011 and August 2014 were reviewed retrospectively. The isokinetic strength of plantar flexion and dorsiflexion of both ankles was assessed on a Cybex dynamometer 3 and 6 months after surgery. Clinical outcomes were evaluated 3, 6, and 12 months post-operatively.
  
  
  RESULTS
  No significant differences were found between the groups regarding patient demographics or activity levels prior to treatment. Significant differences in the Achilles tendon Total Rupture Score, the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score, or the four-point Boyden scale were not found at any time during follow-up. Rerupture occurred only in one patient from group A. No significant differences were observed between the groups regarding the isokinetic plantar flexion and dorsiflexion strength at any time or any test speed.
  
  
  CONCLUSIONS
  Equally favourable clinical outcomes and isokinetic muscle strength and a low complication rate were achieved with the two-stranded single Krackow technique as compared with the four-stranded double Krackow technique for acute Achilles tendon rupture repair.
  
  
  METHODS
  III.
authors: Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, South Korea.
authors: Gi Won
authors: GW
authors: Choi
authors: Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea. hjunkimos@gmail.com.
authors: Hak Jun
authors: HJ
authors: Kim
authors: Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea.
authors: Tae Hoon
authors: TH
authors: Lee
authors: Sports Medical Center, Korea University Guro Hospital, Seoul, South Korea.
authors: Se Hyun
authors: SH
authors: Park
authors: Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, South Korea.
authors: Hee Seop
authors: HS
authors: Lee
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D012189:Retrospective Studies; D012421:Rupture / Q000503:physiopathology / Q000601:surgery; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Achilles tendon rupture; Cybex isokinetic test; Krackow suture; Treatment outcome