Document Detail

Is percutaneous repair better than open repair in acute Achilles tendon rupture?
MedLine Citation:
PMID:  21365335     Owner:  NLM     Status:  MEDLINE    
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.
Hugo Henríquez; Roberto Muñoz; Giovanni Carcuro; Christian Bastías
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-06     Completed Date:  2012-05-16     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  998-1003     Citation Subset:  AIM; IM    
Foot and Ankle Service, Instituto Traumatológico-University of Chile, Avenida San Martín 771, Santiago, Chile.
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MeSH Terms
Achilles Tendon / injuries,  physiopathology,  surgery*
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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