Effectiveness of modified suture technique in treatment of acute closed Achilles tendon rupture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHAN Junfeng , FANG Jialiu , ZHANG Jisen , CHENG Wendan , Lü Hao ,  JING Juehua

Department of Orthopedics, the Second Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230601, P.R.China;

Corresponding?author：

JING Juehua, Email: jingjuehuapaper@163.com

Keywords：

Modified suture technique; acute Achilles tendon rupture; closed injury

DOI：

10.7507/1002-1892.201702090

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

ObjectiveTo investigate the effectiveness of modified suture technique in the treatment of acute closed Achilles tendon rupture.MethodsBetween December 2013 and December 2016, 29 cases with acute closed Achilles tendon rupture were treated with modified suture technique. There were 23 males and 6 females with an average age of 34 years (range, 22-45 years). All patients were sport injuries. The injury located at left side in 22 cases and right side in 7 cases. American Foot and Ankle Surgery Association (AOFAS) ankle and hind foot function score was 44.6±3.6. According to the Amer-Lindholm criteria, 29 cases were rated as poor. MRI showed the complete rupture of the Achilles tendon.ResultsThe operation time was 35-62 minutes (mean, 46 minutes). The intraoperative blood loss volume was 7-15 mL (mean, 10 mL). The incisions healed by first intention, and no sural nerve injury occured. All patients were followed up 5-38 months (mean, 18.4 months). AOFAS ankle and hind foot function score was 93.1±4.3 at 3 months after operation, showing significant difference when compared with the preoperative value (t=–49.581, P=0.000). According to the Amer-Lindholm criteria, the results were excellent in 24 cases and good in 5 cases, and the excellent and good rate was 100%; there was significant difference between pre- and post-operation (Z=–7.294, P=0.000). MRI showed the continuous and integrity of Achilles tendon. No Achilles tendon rupture recurred during the follow-up period.ConclusionModified suture technique in the treatment of acute closed Achilles tendon rupture owns the advantages of less trauma, lower recurrence rate of rupture, lower risk of the sural nerve injury, and satisfactory function recovery.

Citation： ZHAN Junfeng, FANG Jialiu, ZHANG Jisen, CHENG Wendan, Lü Hao, JING Juehua. Effectiveness of modified suture technique in treatment of acute closed Achilles tendon rupture. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 952-956. doi: 10.7507/1002-1892.201702090 Copy

1.	Ganestam A, Kallemose T, Troelsen A, et al. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3730-3737.
2.	高磊, 丁亮華, 孔繁林, 等. 經皮帶線鉚釘治療急性閉合性跟腱斷裂 28 例. 中華創傷雜志, 2014, 30(4): 336-338.
3.	Aktas S, Kocaoglu B, Nalbantoglu U, et al. End-to-end versus augmented repair in the treatment of acute Achilles tendon ruptures. J Foot Ankle Surg, 2007, 46(5): 336-340.
4.	王曉寧, 朱穎波, 黃鑫, 等. 新型微創縫合技術治療急性閉合性跟腱斷裂. 中華創傷骨科雜志, 2016, 18(3): 187-191.
5.	Wang D, Sandlin MI, Cohen JR, et al. Operative versus nonoperative treatment of acute Achilles tendon rupture: An analysis of 12,570 patients in a large healthcare database. Foot Ankle Surg, 2015, 21(4): 250-253.
6.	Cukelj F, Bandalovic A, Knezevic J, et al. Treatment of ruptured Achilles tendon: Operative or non-operative procedure? Injury, 2015, 46 Suppl 6: S137-142.
7.	Ding WG, Zhu YP, Yan WH. Treatment of acute and closed Achilles tendon ruptures by minimally invasive tenocutaneous suturing. J Foot Ankle Surg, 2013, 52(2): 143-146.
8.	Wu Y, Lin L, Li H, et al. Is surgical intervention more effective than non-surgical treatment for acute Achilles tendon rupture? A systematic review of overlapping meta-analyses. Int J Surg, 2016, 36(Pt A): 305-311.
9.	Zhao J, Yu B, Xie M, et al. An Alternative Bundle-to-Bundle Suturing Technique for Repairing Fresh Achilles Tendon Rupture. J Foot Ankle Surg, 2016, 55(4): 881-884.
10.	平安松, 顧潔夫, 徐振華. 跟腱斷裂修復術后的并發癥. 中國修復重建外科雜志, 2004, 18(6): 513-514.
11.	Massoud EI. Repair of fresh open tear of Achilles tendon Tension regulation at the suture line. Foot Ankle Surg, 2011, 17(3): 131-135.
12.	Laver L, Feldman V, Palmanovich E, et al. Treatment of Achilles tendon ruptures. Harefuah, 2016, 155(7): 443-447.
13.	徐海林, 王天兵, 黨育, 等. 急性閉合性跟腱斷裂的微創手術治療. 中華創傷骨科雜志, 2012, 14(1): 36-39.
14.	Porter KJ, Robati S, Karia P, et al. An anatomical and cadaveric study examining the risk of sural nerve injury in percutaneous Achilles tendon repair using the Achillon device. Foot Ankle Surg, 2014, 20(2): 90-93.
15.	楊明, 張曉萌, 張殿英, 等. 兩種微創技術治療跟腱斷裂的比較研究. 中華創傷骨科雜志, 2016, 18(3): 192-196.
16.	Bartel AF, Elliot AD, Roukis TS. Incidence of complications after Achillon^? mini-open suture system for repair of acute midsubstance Achilles tendon ruptures: a systematic review. J Foot Ankle Surg, 2014, 53(6): 744-746.
17.	孫淑紅, 孫臣友, 唐茂林. 跟腱周圍軟組織血供與跟腱斷裂修補術入路選擇的解剖學研究. 中國骨傷, 2007, 20(2): 106-107.

1. Ganestam A, Kallemose T, Troelsen A, et al. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3730-3737.
2. 高磊, 丁亮華, 孔繁林, 等. 經皮帶線鉚釘治療急性閉合性跟腱斷裂 28 例. 中華創傷雜志, 2014, 30(4): 336-338.
3. Aktas S, Kocaoglu B, Nalbantoglu U, et al. End-to-end versus augmented repair in the treatment of acute Achilles tendon ruptures. J Foot Ankle Surg, 2007, 46(5): 336-340.
4. 王曉寧, 朱穎波, 黃鑫, 等. 新型微創縫合技術治療急性閉合性跟腱斷裂. 中華創傷骨科雜志, 2016, 18(3): 187-191.
5. Wang D, Sandlin MI, Cohen JR, et al. Operative versus nonoperative treatment of acute Achilles tendon rupture: An analysis of 12,570 patients in a large healthcare database. Foot Ankle Surg, 2015, 21(4): 250-253.
6. Cukelj F, Bandalovic A, Knezevic J, et al. Treatment of ruptured Achilles tendon: Operative or non-operative procedure? Injury, 2015, 46 Suppl 6: S137-142.
7. Ding WG, Zhu YP, Yan WH. Treatment of acute and closed Achilles tendon ruptures by minimally invasive tenocutaneous suturing. J Foot Ankle Surg, 2013, 52(2): 143-146.
8. Wu Y, Lin L, Li H, et al. Is surgical intervention more effective than non-surgical treatment for acute Achilles tendon rupture? A systematic review of overlapping meta-analyses. Int J Surg, 2016, 36(Pt A): 305-311.
9. Zhao J, Yu B, Xie M, et al. An Alternative Bundle-to-Bundle Suturing Technique for Repairing Fresh Achilles Tendon Rupture. J Foot Ankle Surg, 2016, 55(4): 881-884.
10. 平安松, 顧潔夫, 徐振華. 跟腱斷裂修復術后的并發癥. 中國修復重建外科雜志, 2004, 18(6): 513-514.
11. Massoud EI. Repair of fresh open tear of Achilles tendon Tension regulation at the suture line. Foot Ankle Surg, 2011, 17(3): 131-135.
12. Laver L, Feldman V, Palmanovich E, et al. Treatment of Achilles tendon ruptures. Harefuah, 2016, 155(7): 443-447.
13. 徐海林, 王天兵, 黨育, 等. 急性閉合性跟腱斷裂的微創手術治療. 中華創傷骨科雜志, 2012, 14(1): 36-39.
14. Porter KJ, Robati S, Karia P, et al. An anatomical and cadaveric study examining the risk of sural nerve injury in percutaneous Achilles tendon repair using the Achillon device. Foot Ankle Surg, 2014, 20(2): 90-93.
15. 楊明, 張曉萌, 張殿英, 等. 兩種微創技術治療跟腱斷裂的比較研究. 中華創傷骨科雜志, 2016, 18(3): 192-196.
16. Bartel AF, Elliot AD, Roukis TS. Incidence of complications after Achillon^? mini-open suture system for repair of acute midsubstance Achilles tendon ruptures: a systematic review. J Foot Ankle Surg, 2014, 53(6): 744-746.
17. 孫淑紅, 孫臣友, 唐茂林. 跟腱周圍軟組織血供與跟腱斷裂修補術入路選擇的解剖學研究. 中國骨傷, 2007, 20(2): 106-107.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of modified suture technique in treatment of acute closed Achilles tendon rupture

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content