Open vs. percutaneous suture repair of the subcutaneous Achilles tendon rupture

Abstract The authors assess and compare results of percutaneous and open repair of closed Achilles tendon rupture The authors retrospectively examined 115 patients with subcutaneous Achilles tendon rupture who were treated in the Regional Hospital of Pardubice during the years 2000-2005. They used the 100 point Hannover Achilles Tendon Score. 42 patients were operated on exclusively with percutaneous technique and 73 patients with open repair of Achilles tendon. Duration of the rehabilitation, post-operative complications and using of alternative fixation system in a post-operative treatment of Achilles tendon rupture were also assessed. 62 % of evaluated patients achieved good or excellent results. There was no significant difference between the open and percutaneous repair. In a case of percutaneous repair there was achieved a shortening of post-fixation rehabilitation time in compare with open repair about two weeks. Eighteen postoperative complications were identified after open Achilles tendon repair, resulting in institutional complication rate of 24.7 %. The complications included 6 (8.2%) superficial wound infections. 7 (9.6%) deep crural flebothromboses, 4 (5.5%) re-ruptures and 1 (1.4%) sural nerve injury. Seven postoperative complications were identified after percuaneous Achilles tendon repair, resulting in institutional complication rate of 11.8%. The complications included 3 (7.1%) sural nerve injury and 2 (4.7%) deep crural flebothromboses. The vacuum brace system VacoAchill was used in 23 patients and involved in shortening of duration of rehabilitation about 20%. Percutaneous suture of Achilles tendon rupture is a simple and safety method, that brings comparable functional results to open repair with the same time of post-operative fixation and with a significantly lower rate of complications. The vacuum brace system VacoAchill is an alternative method of post-operative fixation allowing earlier mobilization and shortening patient's disability.