SHORT-TERM EFEECTIVENESS OF SHORT INCISION AND NON-END-TO-END SUTURING SYSTEM FOR ACUTE CLOSED Achilles TENDON RUPTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAOWuchang ^1,2 ,  WANGYingzhen ¹

1. Department of Orthopedics, the Affiliate Hospital of Medical College, Qingdao University, Qingdao Shandong, 266003, P. R. China;
2. Department of Orthopedics, No 7 & Orthopedic Hospital of Zibo;

Corresponding?author：

WANGYingzhen, Email: wangyingzhend@163.com

Keywords：

Acute Achilles rupture; Closed injury; Non-end-to-end suturing system

DOI：

10.7507/1002-1892.20150122

Video：

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Objective To evaluate the short-term effectiveness of the short incision and non-end-to-end suturing system in the treatment of acute closed Achilles tendon rupture. Methods Between September 2011 and September 2013, 22 patients with acute Achilles tendon rupture were treated with self-designed minimally invasive non-end-to-end suturing system. There were 16 males and 6 females, aged from 22 to 55 years (mean, 32.6 years). The left side was involved in 12 cases and the right side in 10 cases. The causes included sports injury in 16 patients, violent injury in 4 patients, and falling injury in 2 patients. MRI revealed that the distance from the ruptured site to the calcaneal tuberosity ranged from 40 to 70 mm (mean, 35 mm). The duration from injury to surgery ranged from 0.5 to 7 days (mean, 4.2 days). The incision of 4 cm in length was made at the initial point of Achilles tendon, and minimally invasive non-end-to-end suturing system was used to hold the Achilles. The ruptured tendon was sutured with two non-absorbed thread. The limb was fixed with plaster for 6 weeks. Results The incision all healed by first intention without complications of sural nerve damage and infection. All patients were followed up 8-14 months (mean, 11 months). According to the Arner-Lindholm functional score criteria, the results were excellent in 19 cases and good in 3 cases. No Achilles tendon rupture happened again during follow-up. Conclusion The small incision with non-end-to-end suturing system is an effective operation strategy for treatment of acute Achilles rupture. The patients can do function exercise at early-stage with satisfatory short-term effectiveness.

Citation： GAOWuchang, WANGYingzhen. SHORT-TERM EFEECTIVENESS OF SHORT INCISION AND NON-END-TO-END SUTURING SYSTEM FOR ACUTE CLOSED Achilles TENDON RUPTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(5): 563-566. doi: 10.7507/1002-1892.20150122 Copy

1.	Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by minimally invasive surgical technique and functional after-treatment. Injury, 2007, 38(7):839-844.
2.	Henríquez H, Mu?oz R, Carcuro G, et al. Is percutaneous repair better than open repair in acute Achilles tendon rupture. Clin Orthop Relat Res, 2012, 470(4):998-1003.
3.	McMahon SE, Smith TO, Hing CB. A meta-analysis of randomized controlled trials comparing conventional to minimally invasive approaches for repair of an Achilles tendon rupture. Foot Ankle Surg, 2011, 17(4):211-217.
4.	王自明. 跟腱的解剖觀察. 衡陽醫學院學報, 1991, 19(1):14-16.
5.	姜楠, 相大勇, 余斌. 急性跟腱斷裂治療的研究進展. 中國修復重建外科雜志, 2013, 27(5):628-632.
6.	Arner O, Lindholm A. Subcutaneous rupture of the Achilles tendon:a study of 92 cases. Acta Chir Scand Suppl, 1959, 116(Supp 239):1-51.
7.	Suchak AA, Bostick G, Reid D, et al. The incidence of Achilles tendon ruptures in Edmonton, Canada. Foot Ankle Int, 2005, 26(11):932-936.
8.	Ma J, Shen J, Smith BP, et al. Bioprotection of tendon repair:adjunctive use of botulinum toxin A in Achilles tendon repair in the rat. J Bone Joint Surg (Am), 2007, 89(10):2241-2249.
9.	商曉軍, 朱亞平, 韋兆祥. 閉合性跟腱斷裂微創腱皮縫合的遠期療效觀察. 中國矯形外科雜志, 2007, 15(18):1371-1373.
10.	李歡, 商曉軍, 朱亞平, 等. 微創腱皮縫合治療急性跟腱斷裂的生物力學評價. 臨床骨科雜志, 2008, 11(3):271-274.
11.	Gigante A, Moschini A, Verdenelli A, et al. Open versus percutaneous repair in the treatment of acute Achilles tendon rupture:a randomized prospective study. Knee Surg Sports Traumatol Arthrosc, 2008, 16(2):204-209.
12.	Lacoste S, Féron JM, Cherrier B. Percutaneous Tenolig(^?) repair under intra-operative ultrasonography guidance in acute Achilles tendon rupture. Orthop Traumatol Surg Res, 2014, 100(8):925-930.
13.	Metz R, Verleisdonk EJ, van der Heijden GJ, et al. Acute Achilles tendon rupture:minimally invasive surgery versus nonoperative treatment with immediate full weightbearing--a randomized controlled trial. Am J Sports Med, 2008, 36(9):1688-1694.
14.	于長隆, 曲綿域, 田得祥, 等. 兔跟腱斷裂修復的實驗病理研究. 中國運動醫學雜志, 1994, 13(1):17-27.
15.	Aktas S, Kocaoglu B, Nalbantoglu U, et al. End-to-end versus augmented repair in the treatment of acute Achilles Tendon raptures. J Foot Ankle Surg, 2007, 46(5):336-340.
16.	Guillo S, Del Buono A, Dias M, et al. Percutaneous repair of acute ruptures of the tendon Achillis. Surgeon, 2013, 11(1):14-19.

1. Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by minimally invasive surgical technique and functional after-treatment. Injury, 2007, 38(7):839-844.
2. Henríquez H, Mu?oz R, Carcuro G, et al. Is percutaneous repair better than open repair in acute Achilles tendon rupture. Clin Orthop Relat Res, 2012, 470(4):998-1003.
3. McMahon SE, Smith TO, Hing CB. A meta-analysis of randomized controlled trials comparing conventional to minimally invasive approaches for repair of an Achilles tendon rupture. Foot Ankle Surg, 2011, 17(4):211-217.
4. 王自明. 跟腱的解剖觀察. 衡陽醫學院學報, 1991, 19(1):14-16.
5. 姜楠, 相大勇, 余斌. 急性跟腱斷裂治療的研究進展. 中國修復重建外科雜志, 2013, 27(5):628-632.
6. Arner O, Lindholm A. Subcutaneous rupture of the Achilles tendon:a study of 92 cases. Acta Chir Scand Suppl, 1959, 116(Supp 239):1-51.
7. Suchak AA, Bostick G, Reid D, et al. The incidence of Achilles tendon ruptures in Edmonton, Canada. Foot Ankle Int, 2005, 26(11):932-936.
8. Ma J, Shen J, Smith BP, et al. Bioprotection of tendon repair:adjunctive use of botulinum toxin A in Achilles tendon repair in the rat. J Bone Joint Surg (Am), 2007, 89(10):2241-2249.
9. 商曉軍, 朱亞平, 韋兆祥. 閉合性跟腱斷裂微創腱皮縫合的遠期療效觀察. 中國矯形外科雜志, 2007, 15(18):1371-1373.
10. 李歡, 商曉軍, 朱亞平, 等. 微創腱皮縫合治療急性跟腱斷裂的生物力學評價. 臨床骨科雜志, 2008, 11(3):271-274.
11. Gigante A, Moschini A, Verdenelli A, et al. Open versus percutaneous repair in the treatment of acute Achilles tendon rupture:a randomized prospective study. Knee Surg Sports Traumatol Arthrosc, 2008, 16(2):204-209.
12. Lacoste S, Féron JM, Cherrier B. Percutaneous Tenolig(^?) repair under intra-operative ultrasonography guidance in acute Achilles tendon rupture. Orthop Traumatol Surg Res, 2014, 100(8):925-930.
13. Metz R, Verleisdonk EJ, van der Heijden GJ, et al. Acute Achilles tendon rupture:minimally invasive surgery versus nonoperative treatment with immediate full weightbearing--a randomized controlled trial. Am J Sports Med, 2008, 36(9):1688-1694.
14. 于長隆, 曲綿域, 田得祥, 等. 兔跟腱斷裂修復的實驗病理研究. 中國運動醫學雜志, 1994, 13(1):17-27.
15. Aktas S, Kocaoglu B, Nalbantoglu U, et al. End-to-end versus augmented repair in the treatment of acute Achilles Tendon raptures. J Foot Ankle Surg, 2007, 46(5):336-340.
16. Guillo S, Del Buono A, Dias M, et al. Percutaneous repair of acute ruptures of the tendon Achillis. Surgeon, 2013, 11(1):14-19.

Chinese Journal of Reparative and Reconstructive Surgery

SHORT-TERM EFEECTIVENESS OF SHORT INCISION AND NON-END-TO-END SUTURING SYSTEM FOR ACUTE CLOSED Achilles TENDON RUPTURE

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