Modified mini-incision “internal splinting” versus percutaneous repair technique of acute Achilles tendon rupture: five year retrospective case-controlled study

Jiang, Xiang; Qian, Shenglong; Chen, Cheng; Wu, Helin; Zhi, Xiaosong; Xu, Dan; Lian, Junhong; Liu, Ximing; Wei, Shijun; Xu, Feng

doi:10.1007/s00264-021-05185-0

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Percutaneous repair significantly reduces interference with the surrounding tissue and avoids wound infection 28 . It is similar to open surgery regarding complication rates and time to return to work, 12 but may result in sural nerve injury 12,13,29 . A retrospective study 30 also found that the incidence of sural nerve injury during percutaneous puncture was as high as 13%.…”

Section: Discussionmentioning

confidence: 99%

“…28 It is similar to open surgery regarding complication rates and time to return to work, 12 but may result in sural nerve injury. 12,13,29 A retrospective study 30 also found that the incidence of sural nerve injury during percutaneous puncture was as high as 13%. During the percutaneous suture technique, repair cannot be visually confirmed because of the soft tissue around the proximal Achilles tendon.…”

Section: Treatment Of Achilles Tendon Rupture and Its Advantages And ...mentioning

confidence: 99%

“…However, the risk of soft‐tissue‐related complications, such as infection and wound nonunion, increases after open treatment for Achilles tendon rupture 8,10,11 . The percutaneous repair technique can avoid these complications, but higher rates of sural nerve injury follow 12,13 . It is difficult for a surgeon to determine the tension of the sutured tendon because the ruptured tendon is not visible.…”

Section: Introductionmentioning

confidence: 99%

“… 8 , 10 , 11 The percutaneous repair technique can avoid these complications, but higher rates of sural nerve injury follow. 12 , 13 It is difficult for a surgeon to determine the tension of the sutured tendon because the ruptured tendon is not visible. The invention of assistive devices such as the Achillon device and the Dresden instrument makes percutaneous sutures more accurate 14 , 15 , 16 ; however, the specificity of these devices has limited the widespread use of these techniques and did not avoid the risk of sural nerve injury.…”

Section: Introductionmentioning

confidence: 99%

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A New Technique of Achilles Tendon Rupture Repaired by Double Transverse Mini‐incision to Avoid Sural Nerve Injury: A Consecutive Retrospective Study

Jin

Liu

et al. 2022

Orthopaedic Surgery

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Objective Percutaneous suture is a classic technique used in Achilles tendon repair. However, the complication rates surrounding the sural nerve remain relatively high. Modified percutaneous repair technology can effectively avoid these complications; however, the surgical procedure is complicated. Hence, the present study was conducted to describe a redesigned repair technique for the Achilles tendon able to avoid sural nerve injury and reduce the complexity of the procedure. Methods Data of patients with acute primary Achilles tendon rupture at our hospital from January 2019 to May 2020 were included. Subjects with expectations for surgical scarring underwent a minimally invasive‐combined percutaneous puncture technique. The surgical time, requirement for conversion to other technologies, and length of postoperative hospitalization were investigated to assess efficacy. The American Orthopedic Foot & Ankle Society (AOFAS) score and the Arner–Lindholm scale (A‐L scale) were used to assess postoperative clinical outcomes (> 24 months). During the 2‐year follow‐up, MRI was performed to observe the healing of the Achilles tendon. In addition, subjective satisfaction with surgical scar healing was recorded. Results Twenty consecutive subjects with an average follow‐up of 28.3 ± 4.5 months (range, 24–41) met the inclusion criteria. None of the 20 enrolled patients required a converted surgical approach. The mean surgical time was 26.9 ± 6.47 min (range, 20–44). None of the patients experienced dysesthesia or anesthesia around the sural nerve. No signs of postoperative infections were observed. MRI data showed that the wounds of the Achilles tendon healed completely in all the subjects. The AOFAS score increased from 55.6 ± 11.07 (range, 28–71) preoperatively to 97.8 ± 3.34 (range, 87–100) at the last follow‐up. The A‐L scale showed that 90% of the subjects (n = 18) presented as excellent and 10% of the subjects (n = 2) presented as good, with an excellent/good rate of 100%. Moreover, subjects' satisfaction for surgical scars was 9.1 ± 0.78 (upper limit, 10). Conclusions The results indicate that this technique can achieve good postoperative function, a small surgical incision, and high scar satisfaction. In addition, this technique should be widely used in suturing Achilles tendon ruptures.

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Section: Discussionmentioning

confidence: 99%

Section: Treatment Of Achilles Tendon Rupture and Its Advantages And ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A New Technique of Achilles Tendon Rupture Repaired by Double Transverse Mini‐incision to Avoid Sural Nerve Injury: A Consecutive Retrospective Study

Jin

Liu

et al. 2022

Orthopaedic Surgery

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Mini-open versus percutaneous surgical repair for acute Achilles tendon rupture: a systematic review and meta-analysis

Melinte,

Nistor,

de Souza Conde

et al. 2024

International Orthopaedics (SICOT)

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Purpose To compare the clinical outcomes and complications of mini-open (MOT) and percutaneous techniques (PT) in the surgical repair of acute Achilles tendon rupture (AATR). Methods We systematically searched PubMed, Scopus, Web of Science, Clinical Trials, and the Cochrane Library for studies comparing MOT with PT for AATR. We assessed functional outcomes, complication rates, and operation time. Statistical analyses were performed using RevMan Web. Odds ratios (ORs) and mean difference (MD) with 95% confidence intervals (CIs) were pooled with a fixed-effects model for dichotomous and continuous endpoints, respectively. Heterogeneity was evaluated with I2 statistics. Results Eight studies, comprising 484 patients, were included, of whom 226 (46%) underwent MOT. MOT was associated with a significantly lower re-rupture rate (1.48% vs. 6.11%; OR 0.28; 95% CI 0.09–0.86; p = 0.03; I2 = 6%) and sural nerve injury rate (0.57% vs. 5.64%; OR 0.24; 95% CI 0.07–0.81; p = 0.02; I2 = 0%). No significant differences were observed in venous thrombosis (OR 0.81; 95% CI 0.17–3.94; p = 0.33; I2 = 0%), wound infection (OR 0.56; 95% CI 0.12–2.62; p = 0.46; I2 = 0%), or operation time (MD 1.83 min; 95% CI -1.13–4.79; p = 0.23; I2 = 88%). Functional outcomes showed higher American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores in the MOT group (MD 1.52 points; 95% CI 0.62–2.42; p = 0.001; I2 = 3%), while (Achilles Tendon Total Rupture Score) ATRS, time to return to activities, and ankle plantar and dorsiflexion were comparable. Conclusions MOT for AATR repair seems to reduce re-ruptures and sural nerve injuries while improving AOFAS scores, with no significant differences in other complications compared to PT. These findings suggest that the MOT may offer a safer and equally effective alternative to PT for AATR.

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Progress in Clinical Treatment of Achilles Tendon Rupture

吴

2024

JCPM

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Modified mini-incision “internal splinting” versus percutaneous repair technique of acute Achilles tendon rupture: five year retrospective case-controlled study

Cited by 4 publications

References 21 publications

A New Technique of Achilles Tendon Rupture Repaired by Double Transverse Mini‐incision to Avoid Sural Nerve Injury: A Consecutive Retrospective Study

A New Technique of Achilles Tendon Rupture Repaired by Double Transverse Mini‐incision to Avoid Sural Nerve Injury: A Consecutive Retrospective Study

Mini-open versus percutaneous surgical repair for acute Achilles tendon rupture: a systematic review and meta-analysis

Progress in Clinical Treatment of Achilles Tendon Rupture

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