Purpose of Study: Once the decision is made to treat an acute Achilles tendon rupture by surgical procedure, the surgeon is confronted with numerous operative techniques. After Ma et al. have described the percutaneous suture, it exists a alternative to the open method. The ad- and disadvantages of both methods or of the conservative treatment are often discussed. It should be inverstigated how the results of operative treatment by percutaneous repair are and if there is a possibiltiy to improve them by the use of a modified technique.

Method: The study includes 76 patients with Achillles tendon rupture, who underwent a percutaneous repair from 1999 to 2003 in our department. The patients were examined on average 26 months. In changing the original technique we used a straight needle for guiding the suture transversly through the wound. In addition the way how the neeedle is pushed into the tendon to adapt the stumps is modified.

Results: All patients could be examined after the operation. The patients, who have done sports before the accident were able to return after the healing time. We saw no superficial or deep wound infection. We had 4 patients with sural nerve injuries, three resolved in six to nine months. There was one patient with a rerupture, who underwent open surgical repair.

Conclusion: The percutaneous suture offers an interesting alternative method to the standard open repair in the treatment of Achilles tendon rupture.