Purpose
Achilles tendon ruptures (ATR) account for approximately one third of all large tendon injuries [1],
with incidence of approximately 18 in 100,000 people [2,
3].
Two main surgical repair techniques (open and percutaneous) are used for treating acute Achilles tendon ruptures.
Controversy still exists regarding the choice of optimal technique,
as long as both of them have their advantages and disadvantages.
After the percutaneous surgery wound complications,
cost,
and subjective patient outcome are higher compared to open surgical repair.
On the other hand,
the open...
Methods and Materials
A randomised study was carried out with 57 patients (mean age years SD; 7 (12,28 %) females,
50 (87,72 %) males),
who have suffered a traumatic rupture in the distal or middle third of the Achilles tendon (29 (50,88 %) right,
28 (49.12 %) left).
Inclusion criteria were an acute (less than two weeks) closed rupture in the distal or middle third of the of Achilles tendon,
patient’s age between 18 to 65 years and the patient’s motivation and agreement to participate.
The patients were...
Results
In both groups elongation of the repaired tendon was observed (difference between the length of the healthy and the repaired tendons measured: OS -2.07 mm,
SD 2.02 mm,
PS -2,48 mm,
SD 2,18 mm),
however,
there was no statistical significance found (p=0.181).
Fig.
6.
There was no statistically significant difference between other measurements as well: the difference between cross-sectional areas of the healthy and surgically treated tendons (OS -2,73 mm2,
SD 1,16 mm2,
PS -2,56 mm2,
SD 0,94 mm2,
p=0.603),
cross-sectional areas of the calf...
Conclusion
Radiologically no significant difference was found between the two surgical repair techniques,
therefore clinical parameters and the surgeons approach should be considered.
Elongation of the repaired tendons was observed in both groups,
regardless of the surgical method used.
This may implicate that their biomechanical qualities may differ,
compared to the healthy tendons.
The long term follow-up findings suggest that the size of the surgically repaired Achilles tendon and calf muscles tends to gradually return to its previous state.
References
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Increasing age in Achilles rupture patients over time.
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Achilles tendon rupture: Avoiding tendon Lengthening during Surgical repair and rehabilitation.
Yale Journal of Biology and Medicine 84 (2011) 289-300
Santrock RD,
Friedmann AJ,
Hanselman AE.
Acute Rupture Open Repair Techniques.
Clin Podiatr Med Surg 34 (2017) 245–250
McMahon SE,
Smith TO,
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A meta-analysis of randomised controlled trials comparing conventional to minimally invasive approaches for...