Ultrasound-assisted minimally invasive percutaneous repair of acute closed Achilles tendon ruptures / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical effect of minimally invasive percutaneous repair of acute closed Achilles tendon ruptures with intraoperative ultrasound assistance.Methods A retrospective case series study was made on 24 patients with acute closed Achilles tendon ruptures hospitalized between January 2013 and June 2015.There were 19 males and five females,aged 18-50 years (mean,30.5 years).MRI showed total Achilles tendon ruptures,and time from injury to operation was 1-3 days.All patients underwent minimally invasive percutaneous repair with high-frequency ultrasound assistance.Operation time and either intraoperative or postoperative complications were documented.At last follow-up,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Arner Lindholm system were used to evaluate ankle functional recovery.Results Operation time was 35-60 minutes (mean,42 minutes).No intraoperative injury to the major vessel and nerve occurred.Follow-up was conducted for 10-18 months (mean,14.5 months).No surgery-related complications were detected,including wound infection,skin necrosis and tendon reruptures.Ankle function was recovered to normal.AOFAS score were improved from preoperative 53-74 points [(61.5-± 6.7)points] to 91-100 points [(97.1 ± 3.2) points] at last follow-up (P ＜ 0.05).According to the Amer Lindholm system,the treatment outcome was excellent in 21 patients and good in three,with the excellence rate of 100％.Conclusion Ultrasound-assisted minimally invasive percutaneous technique improves the quality of tendon anastomosis,avoids injury to the sural nerve,minimizes the incidence rate of complications such as re-rupture,wounds infections or skin necrosis and hence is an ideal method for repair of acute closed Achilles tendon ruptures.