Background
Although percutaneous repair of Achilles tendon rupture avoids possible complications of open repair as well as conservative treatment, sural nerve injury and re-rupture are the potential complications of percutaneous technique. Here, we describe a surgical technique to minimize the risk of sural nerve injury.
Patients and methods
This study included 22 patients with complete Achilles tendon rupture treated using the presented percutaneous technique within a mean of 8.5 days (2–28 days) of injury. There were 18 men and four women, with a mean age of 34.7 years (25–48 years). Clinical examination, ankle plain radiograph, and Achilles tendon MRI were done for all patients. All patients were followed up for a mean of 26 months (18–40 months).
Results
For 22 patients over the period of follow-up, the mean American Orthopedic Foot and Ankle Society Score was 92.81 (82–100). MRI showed satisfactory healing of the Achilles tendon in all patients at 3 months. All patients had a nearly full range of ankle movement recovery at the latest follow-up. The mean time interval from repair to return to work was 7.54 weeks. There was neither sural nerve injury nor re-rupture observed during the follow-up period.
Conclusion
The presented percutaneous technique is easy and safe, with a low rate of complications. This technique avoids the possible complications of conservative management and open surgery with neither re-rupture nor sural nerve injury, as the percutaneous sutures are not placed in the lateral half of the Achilles tendon proximal to rupture site.