Aims

The surgical management of ankle arthritis with tibiotalar arthrodesis is known to alter gait, as compared with normal ankles. The purpose of this study was to assess post-operative gait function with gait before arthrodesis.

Background: 75% of Achilles tendon ruptures are related to physical activities.

The best method of treatment for acute Achilles tendon rupture is still debated. Treatment options can be classified as Nonoperative based on cast immobilization, open surgery, and percutaneous surgery based on passing sutures through several stab incisions.

Common complications include re-ruptures, infection, wound problems and sural nerve injury. Recent reports of percutaneous surgery show good functional outcome, low incidence of re-ruptures, fewer wound healing problems and prompt recovery.

Objective: Assessment of percutaneous operative treatment outcome.

Methods: 73 patients treated for acute Achilles tendon rupture with percutaneous surgery in the past eight years are followed. Evaluations were preformed at an average of 34.6 months postoperatively (range, 17 to 54 months). Outcome was evaluated by analyzing Epidemiologic, subjective and objective parameters.

Results: The patients demonstrated good functional outcome, with none – to mild limitations in recreational activities. Ankle range of motion was not statistically different between both ankles. Evaluation of strength and power with the Cybex II dynamometer revealed a difference at 240 deg/sec for plantar flexion power between the injured and healthy leg, but no difference at 30 and 90 deg/sec, or in dorsiflexion power and strength.

Complication rate was low: sural nerve injury (1 patient), superficial wound infection (2 patients), suture granuloma (4 patients) and re-rupture (1 patient).

Conclusions: In our series, percutaneous operative treatment was found to be simple, fast and can be done under local anesthesia. Our low complication rate and excellent functional results make this treatment an appealing alternative to either conservative or open surgical suture.