Abstract:

Objective　To evaluate minimally invasive versus conventional methods for repair of acute Achilles tendon rupture.    Methods    40 cases of patients with acute achilles tendon rupture, broken end in the calcaneal tuberosity of proximal 2~8 cm, were divided into two groups, of which 20 patients in the experimental group were treated with minimally invasive surgery with small incision 3 cm in length using the oval forceps and epidural needle while 20 patients in the control group adopted conventional surgical treatment of tendon with a medial incision 8 cm in length. Polymer splint immobilization was used to keep the foot in a position of plantar flexion 4 weeks after surgery, and in the neutral position for 2 weeks. ALL cases need hydrotherapy and stretching and isometric contraction training after removal of external fixation 6 weeks later.   Results     After operation, 17 cases in the experimental group and 16 cases in the control group were followed up for 16~24 months, averaging 21 months. The therapeutic efficacy of the two treatment modalities was evaluated according to the Arner-indholm score standard six months after surgery.  The excellent and good rate and skin necrosis rate of observation group were significantly higher than that in the control group (P<0.05).    Conclusion    For acute Achilles tendon rupture, the small–incision approach carried out with oval forceps and epidural needle is simple in operation, reliable in anastomosis, milder in trauma, lower in skin necrosis rate, better in functional recovery than the control group. Minimally invasive surgery performed with the oval forceps and epidural needle for treatment of rupture of the Achilles tendon has good efficacy, and it is worthy of wider promotion for its application in grassroot hospitals.

Key words: Achilles tendon rupture, Minimally invasive, Conventional method