Comparison of percutaneous minimally invasive suture versus conventional open suture for acute closed rupture of Achilles tendon / 中华创伤骨科杂志

ABSTRACT

Objective To compare the clinical outcomes between percutaneous minimally invasive suture versus conventional open suture for acute closed rupture of Achilles tendon.Methods A prospective study was performed in the 68 patients who had been treated for acute occlusive rupture of Achilles tendon from November 2010 to November 2013 at Department of Orthopedic Trauma, The Third Affiliated Hospital to Soochow University. They were randomly assigned by the sequence of medical attention to receive percutaneous minimally invasive suture or conventional open suture. In the conventional group, there were 31 men and 3 women with an average age of 37.0 ± 10.0 years; in the minimally invasive group, there were 30 men and 4 women with an average age of 36.4 ± 9.4 years. The 2 groups were compared in terms of operation time, intraoperative bleeding, postoperative wound infection, postoperative skin necrosis and ankle-hindfoot score of American Orthopaedic Foot and Ankle Society ( AOFAS ) . Results All the 68 cases were fol-lowed up for an average of 21.26 months ( from 6 to 36 months ). There were no significant differences between the 2 groups in operation time ( 75.0 ± 5.3 min versus 64.8 ± 3.8 min ) or in rate of postoperative local in-fection [ 2.9% ( 1/34 ) versus 14.7% ( 5/34 ) ] ( P ＞ 0.05 ). The minimally invasive group had significantly less intraoperative bleeding ( 12.0 mL ) , a significantly lower rate of skin necrosis [ 2.9% ( 1/34 ) ] and significantly higher AOFAS scores at 6 ( 90.5 ) , 12 ( 91.5 ) and 24 months ( 93.5 ) postoperatively than the conventional group did ( 80.0, 81.0 and 82.5, respectively ) ( all P ＜0.05 ). Conclusion Percuta-neous minimally invasive suture is recommendable for treatment of acute closed rupture of Achilles tendon because it leads to less intraoperative bleeding, better postoperative functional recovery and lower incidence of postoperative skin necrosis.