Introduction: Achilles tendinopathy (AT) is the most common over use syndrome of the lower limb. One of the simple operations performed for this condition is “Multiple longitudinal tenotomies”. This can be performed by either percutaneous or open methods. We compared the outcome of percutaneous versus open method of multiple longitudinal tenotomies for this condition.

Methods and materials: It is a retrospective study of patients operated for AT in our hospital from 1997 to 2008. Total of 43 patients. Twenty had percutaneous and 23 had open tenotomies. All of them had a trial of non-operative treatment prior to surgery, in the form of analgesia, physiotherapy, heel inserts, and ultrasound therapy. Data was collected from patient records and by telephonic questionnaire of the patients. Data collected includes pre and postoperative pain scores on a scale of 0–10, duration of symptoms, patient satisfaction scores (0–10) and complications. This questionnaire also included limitation to walk, run, going up/down the stairs, work and sporting activities.

Results: In the percutaneous group the mean pre and postoperative pain scores were 8.79 and 2.07 (p value 0.000). In the open group the values were 8.65 and 1.75 (p value 0.000). The mean satisfaction scores in the percutaneous and open groups were 8.25 (range 3–10) and 8.14(range2–10) respectively. The patient satisfaction scores were not significantly different between the two groups (p value 0.942). In the percutaneous group there was one recurrence and in one patient there was no symptomatic relief. In the open group there were 2 superficial infections, which settled with antibiotics and a wound breakdown, which in addition required debridement and eventually healed by secondary intension.

Conclusions: Both percutaneous and open methods of longitudinal tenotomies resulted in significant symptomatic relief and good patient satisfaction scores. Although the outcomes of both groups were comparable the percutanous method has an added advantage of less complications and simplicity of the procedure.

Objective: The main objective of our study was to compare the outcome and complications between open and percutaneous tennis elbow release using the Total Elbow Scoring System (TESS). Our null hypothesis is that there is no difference in patient based outcome measures and morbidity between both groups.

Methods: We evaluated a cohort of 40 patients (41 elbows) with clinical evidence of tennis elbow that had surgery after failed conservative treatment. All patients were followed up for a minimum of 12 months and information entered into a structured questionnaire. Other outcomes measures assessed include; Visual Analogue Score (VAS), length of time to return to work, and wound complications.

Results: Seventeen (17) and Twenty-four (24) elbows were managed by percutaneous release and open surgery respectively. There were twenty-one female patients (22 elbows) and nineteen male patients (19 elbows). The mean age of the study population was 45years (s.d.: 8.4yrs). The mean duration of symptoms before surgery was 20 months (s.d.: 9.1mths). All 17 elbows that had percutaneous release procedures had a TESS score greater than 80, in comparison to 19 out of 24 elbows with open procedures, although this was not quite significant. (p=0.06). A score of between 80 and 100 is considered good or excellent. Patients that had open surgery had a significantly higher pain (Visual analogue score) VAS in comparison to closed procedures (p=0.01).

A significantly higher proportion of patients that had percutaneous procedures were able to return to work within 2 weeks in comparison to open procedures (p-=0.03). There were 4 cases of wound complication that occurred only in patients with open surgery.

Conclusion: We conclude that percutaneous release for tennis elbow can produce satisfactory outcomes, with lower morbidity and earlier return to work compared with open procedures.

Thirty-three consecutive patients with complete ruptures of the calcaneal tendon were treated by external fixation. The patients were assessed both objectively and subjectively, and the results classified as excellent, good, fair and poor. In 30 patients the result was excellent or good. There were no infections or re-ruptures. Two patients with fair results had sural nerve injury. The only patient with a poor result had Sudeck's atrophy. It is felt that this operation satisfies the need for a new technique which is simple and combines the advantages of both surgical and non-surgical treatment without their major complications.