The incidence of closed Achilles rupture is on rise year after year reflecting the increased sports and recreational activites and life style diseases. The disability both long term and short term are profound if not promptly diagnosed and properly treated. The complications of non-operative treatment and conventional open surgical procedures are well known and documented.
Materials & Methods: Thirty patients with acute closed rupture of Achilles tendon were treated between 2010 and 2015 using a new technique of percutaneous repair using cannula. Twenty four patients were males and six patients were females. 20 patients were between 40 and 50 years of age. 8 patients were between 30 and 40 years of age while 2 patients were above 50 years of age. The mean time between injury and index surgery was 8 days (range 5 to 14 days).
Results: The average range of ankle plantar flexion was 130° (range, 120°-140°) on the repaired side and 143° (range, 120°- 155°) on the non-injured side. The average range of ankle dorsiflexion was 17° (range, 16°-21°) on the operated side and 19° (range, 18°-22°) on the non- injured side. The mean calf diameter was 40.5 cm (range, 37-44 cm) on the operated side and 42.5 cm (range, 39-45 cm) on the non- injured side. The interval between injury and return to regular work was 13 weeks (range 10-16 weeks). The mean AOFAS score was 90 (80-98) at the most recent follow-up and 80% of patients’ results were considered excellent while 20% were good. There was no re-rupture, skin necrosis or sural nerve injury in our series.
Conclusions: Percutaneous “cannula” technic repair of closed tendo Achilles rupture is an excellent and simple outpatient technic without much possibility of soft tissue complications. The only drawback of this technique is the possibility of sural nerve injury. This can be eliminated by close puncture of the tendon on lateral side.