EFFECTIVENESS COMPARISON BETWEEN MODIFIED PERCUTANEOUS SUTURE AND CONVENTIONAL OPEN SUTURE IN REPAIRING ACUTE CLOSED Achilles TENDON RUPTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHU Haikun ^1,2 , XU Yanbin ³ , CHU Haipeng ⁴ , XU Yajun ⁵ , ZHOU Fengji ¹ , YU Xin ¹ , LI Hui ¹ , JI Xiaofeng ¹

1Department of Orthopaedics, China and Japan Union Hospitalof Jilin University, Changchun Jilin,130000, P.R.China;;
2Department of Orthopaedics, 5Department of Pharmacy, Daqing Oilfield General Hospital;;
3Department of Orthopaedics, the 4th People’s Hospital of Siping City;;
4Department of Obstetrics and Gynecology, Daqing Longnan Hospital.;

Corresponding author：

Keywords：

Closed Achilles tendon rupture; Modified percutaneous suture; Tendon repair

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Objective To investigate the effectiveness of modified percutaneous suture in repairing acute closed Achilles tendon rupture by comparing with conventional open suture. Methods Between January 2006 and October 2009, 50 patients with acute closed Achilles tendon rupture were treated with modified percutaneous suture by making 5 small incisions at both sides of Achilles tendon and zigzag suture (improved group, n=22) and with Kessler suture (conventional group, n=28), respectively. No significant difference was found in gender, age, time from injury to operation between 2 groups (P gt; 0.05). Results In improved group, the patients achieved healing of incisions by first intention after operation and no
complication occurred; however, incision infection occurred in 1 case, Achilles tendon re-rupture in 1 case, and incision scar contracture in 2 cases in conventional group. The operation time of improved group [(38.7 ± 6.6) minutes] was significantly shorter (t= —12.29, P=0.00) than that of conventional group [(52.3 ± 6.9) minutes]; the blood loss of improved group [(4.9 ± 2.0) mL] was significantly less (t= —25.20, P=0.00) than that of conventional group [(40.7 ± 7.1) mL]. The patients were followed up 2-3 years (mean, 29.9 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was 99.6 ± 1.0 in improved group and was 98.4 ± 3.0 in conventional group, showing no significant difference between 2 groups (t=1.66, P=0.10). Conclusion Comparison with conventional open suture, modified percutaneous suture has some advantages, such as easy operation, less complications, rapid recovery of limb function, and so on. Modified percutaneous suture is one of the best choices for the treatment of acute closed Achilles tendon rupture.

Citation： CHU Haikun,XU Yanbin,CHU Haipeng,XU Yajun,ZHOU Fengji,YU Xin,LI Hui,JI Xiaofeng. EFFECTIVENESS COMPARISON BETWEEN MODIFIED PERCUTANEOUS SUTURE AND CONVENTIONAL OPEN SUTURE IN REPAIRING ACUTE CLOSED Achilles TENDON RUPTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(6): 708-711. doi: Copy

1.	Khan RJ, Fick D, Keogh A, et al. Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg (Am), 2005, 87(10): 2202-2210.
2.	Cetti R, Christensen SE, Ejsted R, et al. Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med, 1993, 21(6): 791-799.
3.	Cretnik A, Kosanović M, Smrkolj V. Percutaneous suturing of the ruptured Achilles tendon under local anesthesia. J Foot Ankle Surg, 2004, 43(2): 72-81.
4.	张国柱, 蒋协远, 王满宜. 有限切开腱周内缝合法治疗新鲜闭合性跟腱断裂. 山东医药, 2010, 50(44): 22-24.
5.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
6.	商晓军, 朱亚平, 韦兆祥. 闭合性跟腱断裂微创腱皮缝合的远期疗效观察. 中国矫形外科杂志, 2007, 15(18): 1371-1373.
7.	Maes R, Copin G, Averous C. Is percutaneous repair of the Achilles tendon a safe technique? A study of 124 cases. Acta Orthop Belg, 2006, 72(2): 179-183.
8.	Bosworth DM. Repair of defects in the tendo Achillis. J Bone Joint Surg (Am), 1956, 38-A(1): 111-114.
9.	Sato M, Maeda M, Kurosawa H, et al. Reconstruction of rabbit Achilles tendon with three bioabsorbable materials: histological and biomechanical studies. J Orthop Sci, 2000, 5(3): 256-267.
10.	Suchak AA, Spooner C, Reid DC, et al. Postoperative rehabilitation protocols for Achilles tendon ruptures: a meta-analysis. Clin Orthop Relat Res, 2006, (445): 216-221.
11.	Ajis A, Maffulli N. Management of acute tendo Achilles ruptures. Foot Ankle Surg, 2007, 13: 132-135.
12.	Poynton AR, O’Rourke K. An analysis of skin perfusion over the Achilles tendon in varying degrees of plantarflexion. Foot Ankle Int, 2001, 22(7): 572-574.
13.	Costa ML, MacMillan K, Halliday D, et al. Randomised controlled trials of immediate weight-bearing mobilization for rupture of the tendo Achillis. J Bone Joint Surg (Br), 2006, 88(1): 69-77.
14.	Ingvar J, Tägil M, Eneroth M. Nonoperative treatment of Achilles rupture: 196 consecutive patients with a 7% re-rupture rate. Acta Orthop, 2005, 76(4): 597-601.
15.	Wada A, Kubota H, Akiyama T, et al. Effect of absorbable polydioxanone flexor tendon repair and restricted active mobilization in a canine model. J Hand Surg (Am), 2001, 26(3): 398-406.

1. Khan RJ, Fick D, Keogh A, et al. Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg (Am), 2005, 87(10): 2202-2210.
2. Cetti R, Christensen SE, Ejsted R, et al. Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med, 1993, 21(6): 791-799.
3. Cretnik A, Kosanović M, Smrkolj V. Percutaneous suturing of the ruptured Achilles tendon under local anesthesia. J Foot Ankle Surg, 2004, 43(2): 72-81.
4. 张国柱, 蒋协远, 王满宜. 有限切开腱周内缝合法治疗新鲜闭合性跟腱断裂. 山东医药, 2010, 50(44): 22-24.
5. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
6. 商晓军, 朱亚平, 韦兆祥. 闭合性跟腱断裂微创腱皮缝合的远期疗效观察. 中国矫形外科杂志, 2007, 15(18): 1371-1373.
7. Maes R, Copin G, Averous C. Is percutaneous repair of the Achilles tendon a safe technique? A study of 124 cases. Acta Orthop Belg, 2006, 72(2): 179-183.
8. Bosworth DM. Repair of defects in the tendo Achillis. J Bone Joint Surg (Am), 1956, 38-A(1): 111-114.
9. Sato M, Maeda M, Kurosawa H, et al. Reconstruction of rabbit Achilles tendon with three bioabsorbable materials: histological and biomechanical studies. J Orthop Sci, 2000, 5(3): 256-267.
10. Suchak AA, Spooner C, Reid DC, et al. Postoperative rehabilitation protocols for Achilles tendon ruptures: a meta-analysis. Clin Orthop Relat Res, 2006, (445): 216-221.
11. Ajis A, Maffulli N. Management of acute tendo Achilles ruptures. Foot Ankle Surg, 2007, 13: 132-135.
12. Poynton AR, O’Rourke K. An analysis of skin perfusion over the Achilles tendon in varying degrees of plantarflexion. Foot Ankle Int, 2001, 22(7): 572-574.
13. Costa ML, MacMillan K, Halliday D, et al. Randomised controlled trials of immediate weight-bearing mobilization for rupture of the tendo Achillis. J Bone Joint Surg (Br), 2006, 88(1): 69-77.
14. Ingvar J, Tägil M, Eneroth M. Nonoperative treatment of Achilles rupture: 196 consecutive patients with a 7% re-rupture rate. Acta Orthop, 2005, 76(4): 597-601.
15. Wada A, Kubota H, Akiyama T, et al. Effect of absorbable polydioxanone flexor tendon repair and restricted active mobilization in a canine model. J Hand Surg (Am), 2001, 26(3): 398-406.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS COMPARISON BETWEEN MODIFIED PERCUTANEOUS SUTURE AND CONVENTIONAL OPEN SUTURE IN REPAIRING ACUTE CLOSED Achilles TENDON RUPTURE

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