Foot and Ankle Surgery
Volume 16, Issue 3 , Pages 122-125, September 2010

“Mini-open” repair of acute tendo Achilles ruptures—The solution?

  • C. Mukundan, MRCS
    • ,
  • M. El Husseiny, MRCS
    • ,
  • F. Rayan, MRCSEd

      Affiliations

    • Corresponding Author InformationCorresponding author at: University College London Hospitals/The Princess Grace Hospital, 42-52 Nottingham Place, London W1M 3FD, United Kingdom. Tel.: +44 020 7935 6083; fax: +44 020 7935 6728.
    • ,
  • J. Salim, FRCS
    • ,
  • A. Budgen, FRCS

York Hospitals NHS Foundation Trust, York Hospital, Wigginton Road, York, YO31 8HE, United Kingdom

Received 28 December 2008; received in revised form 19 July 2009; accepted 28 July 2009. published online 09 September 2009.

Abstract 

Background

The standard surgical exposure for repair of acute tendo Achilles rupture gives favourable results, but such extensive exposure increases the possibility of peritendinous adhesion, wound breakdown and infections which increases morbidity and impairs functional outcome. Open repair also increases post-operative hospital stay and hence encroaches on valuable bed space availability. To evade this mini-open technique was developed which provide anatomic apposition of the tendon ends and minimal damage to epitendon.

Methods

We describe a retrospective case series of 21 patients who were treated with mini-open technique as a day case, between 2004 and 2007 operated by a single surgeon. They were followed up for a year. Both the Leppilahti score and the American Orthopaedic Foot and Ankle Society for the Ankle Hind foot Clinical Rating System (AOFAS) were calculated. The patients (8 males and 13 females) had a mean age of 43.4 years. Post-operatively the leg was placed in an air cast boot with 3 heel wedges allowing 30 degrees of plantar flexion. The foot is brought into plantigrade position by 6 weeks with serial removal of heel wedges followed by a rehabilitative training programme.

Results

There was one superficial infection which settled on oral antibiotics, no re-rupture or sural nerve involvement was noted in this series. All patients returned to previous work and sports activities. All patients scored above 90 in the American Orthopaedic Foot and Ankle Hind foot Clinical Rating System and on the Leppilahti Scoring System. Mini-open procedure is an excellent alternative to open exposures reducing the inpatient post-operative stay. All patients were discharged home on the same day of the procedure.

Conclusion

Our pilot study has helped us to implement a standardised pathway by which patients have benefitted with improved rehabilitation and return to their pre-injury status.

Keywords: Tendon, Achilles, Rupture, Mini-open repair

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S1268-7731(09)00098-8

doi:10.1016/j.fas.2009.07.005

Foot and Ankle Surgery
Volume 16, Issue 3 , Pages 122-125, September 2010

Article Tools

* Image Usage & Resolution