J Korean Foot Ankle Soc JKFAS Journal of Korean Foot and Ankle Society 1738-3757 2288-8551 Korean Foot and Ankle Society 10.14193/jkfas.2018.22.2.68 Original Article Comparative Study of Clinical Outcome of Three Surgical Techniques in the Achilles Tendon Rupture: Open Repair, Percutaneous Repair, and Minimal Incision Repair by Achillon Park Won Seok * https://orcid.org/0000-0002-4388-7196 Lee Myoung Jin Kang Jung Mo Lee Seung Yup Department of Orthopaedic Surgery, Dong-A University Hospital, Busan, Korea. Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea. Corresponding Author: Myoung Jin Lee. Department of Orthopaedic Surgery, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea. Tel: 82-51-240-2898, Fax: 82-51-243-9764, tynitus@dau.ac.kr 06 2018 15 06 2018 22 2 68 73 09 05 2018 05 06 2018 07 06 2018 Copyright © 2018 Korean Foot and Ankle Society 2018 Korean Foot and Ankle Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

This study compared the clinical outcomes of open repair, percutaneous repair, and minimal incision repair by Achillon in ruptured Achilles tendon.

 Materials and Methods

The outcomes of 12 patients with open repair (group 1), 8 patients with percutaneous repair (group 2), and 10 patients with minimal incision repair by Achillon (group 3) from February 2013 to March 2016 were analyzed retrospectively. The postoperative clinical evaluations were done by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Arner-Linholm scale, mid-calf circumference difference, one-leg heel raise difference, visual analogue scale (VAS) for postoperative scarring, time to return to work, and complications.

 Results

No significant difference in the AOFAS ankle-hindfoot score, Arner-Linholm scale, and time to return to work was observed among three groups (p=0.968, 0.509, and 0.585). The mean differences in the mid-calf circumference in groups 1, 2, and 3 were 1.09, 0.73, and 0.58, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.002). In addition, the mean VAS scores for postoperative scarring in groups 1, 2, and 3 were 7.0, 9.1, and 9.1, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.001). The mean differences in one-leg heel raising in groups 1, 2, and 3 were 2.03, 1.91, and 1.33, respectively; group 3 was significantly higher than groups 1 and 2 (p=0.010). The complications encountered were one case of deep infection in group 1 and one case of sural nerve hypoesthesia in group 2.

 Conclusion

Minimal incision repair by Achillon is recommended as an effective surgical treatment for Achilles tendon rupture because it minimizes the risk of complications, leads to an improved tendon strength and healing, and achieves cosmetic satisfaction.

 Achilles tendon Rupture Open repair Percutaneous repair Achillon

The point of this thesis was presented by 27th Autumn Congress of Korean Foot and Ankle Society.

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Values are presented as number only or mean (range).

 Clinical and Functional Results of Three Groups at the Last Follow-up

Values are presented as mean (range) or number only.

AOFAS: American Orthopaedic Foot and Ankle Society, MMC: mid-calf circumference, VAS: visual analogue scale.