Abstract: Background: Achilles tendon is the strongest and thickest tendon in the human body. Rupture of the Achilles tendon usually occurs in middle-aged population following recreational activities. Incidence rate of these ruptures range from 6 to 18 per 100000 population. Several operative and non-operative treatment options are available. Operative methods include percutaneous, mini-open, open Achilles repair etc. Open repairs carry an increased risk of wound healing problems, whereas minimally invasive techniques are reported to have an increased risk of iatrogenic nerve injury.
Materials and Methods: Twenty patients with acute closed traumatic Tendo Achilles rupture were operated using above mentioned technique between January 2010 to June 2017 in Bangalore out of which 15 were males and 5 were females. Patient was put on anterior below knee slab in plantar flexion of the foot for 2 weeks followed by walking below knee cast for 4 weeks. Patients were followed up at 6 weeks, 3 months, 6 months and 1 year following surgery and complications if any were observed. Postoperative AOFAS ankle – hindfoot score was taken at last follow up.
Result: Percutaneous Tendo Achilles repair has a good outcome in 90% of the cases. There was one case with complication. The complication was sural nerve hypoesthesia but with no functional disability. The average AOFAS score was 89% (76-92) in which 65% (13) were considered excellent, 30% (6) were considered good and 05% (1) were considered fair outcome. There were no re-ruptures.
Conclusion: We present our technique of percutaneous Tendo Achilles repair which has minimal wound and nerve injury complications, early return to activities with a good functional outcome, distal bony fixation with the use of suture anchors reducing the number of suture-tendon interfaces which in turn reduces the chance of failure. It also decreases overall operative time. However further studies are required.
