| Is percutaneous repair better than open repair in acute Achilles tendon rupture? | |
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MedLine Citation:
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PMID: 21365335 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Open repair of Achilles tendon rupture has been associated with higher levels of wound complications than those associated with percutaneous repair. However, some studies suggest there are higher rerupture rates and sural nerve injuries with percutaneous repair. QUESTIONS/PURPOSES: We compared the two types of repairs in terms of (1) function (muscle strength, ankle ROM, calf and ankle perimeter, single heel rise tests, and work return), (2) cosmesis (length scar, cosmetic appearance), and (3) complications. PATIENTS AND METHODS: We retrospectively reviewed 32 surgically treated patients with Achilles rupture: 17 with percutaneous repair and 15 with open repair. All patients followed a standardized rehabilitation protocol. The minimum followup was 6 months (mean, 18 months; range, 6-48 months). RESULTS: We observed similar values of plantar flexor strength, ROM, calf and ankle perimeter, and single heel raising test between the groups. Mean time to return to work was longer for patients who had open versus percutaneous repair (5.6 months versus 2.8 months). Mean scar length was greater in the open repair group (9.5 cm versus 2.9 cm). Cosmetic appearance was better in the percutaneous group. Two wound complications and one rerupture were found in the open repair group. One case of deep venous thrombosis occurred in the percutaneous repair group. All complications occurred before 6 months after surgery. We identified no patients with nerve injury. CONCLUSIONS: Percutaneous repair provides function similar to that achieved with open repair, with a better cosmetic appearance, a lower rate of wound complications, and no apparent increase in the risk of rerupture. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. |
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Authors:
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Hugo Henríquez; Roberto Muñoz; Giovanni Carcuro; Christian Bastías |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Clinical orthopaedics and related research Volume: 470 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-03-06 Completed Date: 2012-05-16 Revised Date: 2013-04-01 |
Medline Journal Info:
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Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
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Languages: eng Pagination: 998-1003 Citation Subset: AIM; IM |
Affiliation:
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Foot and Ankle Service, Instituto Traumatológico-University of Chile, Avenida San Martín 771, Santiago, Chile. hhenriquezs@yahoo.com.ar |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Achilles Tendon
/
injuries,
physiopathology,
surgery* Adult Female Humans Male Middle Aged Orthopedic Procedures / methods* Range of Motion, Articular / physiology Recovery of Function / physiology Retrospective Studies Rupture / physiopathology, surgery* Tendon Injuries / physiopathology, surgery* Treatment Outcome Wound Healing / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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