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The percutaneous oval forceps suture-guiding method with anchor nails for Achilles tendon repair

  • Gaole Dai
    Affiliations
    Gaole Dai is affiliated to Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University. Other authors are affiliated to The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
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  • Yijing Zheng
    Affiliations
    Gaole Dai is affiliated to Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University. Other authors are affiliated to The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
    Search for articles by this author
  • Xiaolang Lu
    Affiliations
    Gaole Dai is affiliated to Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University. Other authors are affiliated to The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
    Search for articles by this author
  • Yang Liu
    Affiliations
    Gaole Dai is affiliated to Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University. Other authors are affiliated to The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
    Search for articles by this author
  • Qihao Weng
    Affiliations
    Gaole Dai is affiliated to Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University. Other authors are affiliated to The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
    Search for articles by this author
  • Jianjun Hong
    Correspondence
    Corresponding author at: 109# Xueyuan Road, Wenzhou 325027 Zhejiang, China.
    Affiliations
    Gaole Dai is affiliated to Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University. Other authors are affiliated to The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
    Search for articles by this author
Published:September 11, 2021DOI:https://doi.org/10.1016/j.injury.2021.09.007

      Highlights

      • A new technique for percutaneous repair of AT: a percutaneous oval forceps suture-guiding method with anchor nails.
      • Several advantages of this technique are as follows: 1) it is possible to repair AATR within 2 cm from the calcaneal tuberosity; 2) the operative procedure is simple and quick; 3) American Orthopedic Foot and Ankle Society (AOFAS) score and Achilles tendon total rupture score (ATRS) showed good clinical outcome; 4) overall complication rate was 6.2% with one sural nerve damage and one fusiform thickening.

      Abstract

      Background

      Acute Achilles tendon rupture (AATR) is a common injury of the foot and ankle. So far, the optimal management of AATR remains controversial. The target of the present retrospective study was to describe a new operative technique for percutaneous repair of AATR and evaluate efficacy of the technique.

      Methods

      In the present study, 32 patients were enrolled with AATR treated with the percutaneous oval forceps suture-guiding method with anchor nails from Jan 2014 to Jan 2017. The operation duration and length of incision were collected. The functional outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score, Achilles tendon total rupture score (ATRS), range of motion (ROM) of the ankle and plantar flexion strength ratio at the last follow-up. The postoperative sports activity level and complications were also recorded.

      Results

      The mean operation duration and length of incision were 24.5 min and 2.0 cm. Whilst patient reported outcome questionnaires like AOFAS and ATRS showed good results, ROM of the ankle was quite low with only 16.5 degrees. Plantar flexion strength ratio was lower post surgery, as well. As for the postoperative sports activity level: 26/32 cases (81.3%) returned to former sports activity level; 4/32 cases (12.5%) showed a decline in sports activity level; 2/32 cases (6.2%) gave up on sports. The overall complication rate was 6.2%, one sural nerve damage and one fusiform thickening were found in the study.

      Conclusion

      The percutaneous oval forceps suture-guiding method with anchor nails is a new considerable surgery method with adequate healing rates and an alternative to existing surgical procedures.

      Keywords

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