Repair of distal Achilles tendon rupture and reattachment

Michael Carmont, Gordon MacKay, William Ribbans

    Research output: Contribution to Book/ReportChapterpeer-review

    Abstract

    Minimally invasive and percutaneous Achilles tendon repair technique allows direct visualization of end-to-end apposition of the ruptured tendon ends whilst minimizing risks of wound breakdown and infection and improving cosmesis. Although they have these advantages, traditional percutaneous repair techniques have been estimated to have half the strength of open repair methods and also present a risk of iatrogenic sural nerve injury. Biomechanical studies have compared box, Bunnell, modified Bunnell, Kessler and Krackow suture configurations in tendon repair models. The mode of failure of percutaneous repair models is the most commonly suture pull out of the distal Achilles stump, at the tendon suture interface. This leads to the separation of the apposed tendon ends and elongation of the healing tendon. In stronger Krackow sutures, with locking loops, failure tends to occur at the suture knots; however, the insertion of these sutures requires greater access and an open repair.
    Original languageEnglish
    Title of host publicationThe Achilles Tendon
    Subtitle of host publicationAn Atlas of Surgical Procedures
    PublisherSpringer
    Chapter6
    Pages31-36
    ISBN (Electronic)9783662540749
    ISBN (Print)9783662540732
    DOIs
    Publication statusE-pub ahead of print - 22 Apr 2017

    Keywords

    • Achilles Tendon
    • Plantar Flexion
    • Suture Anchor
    • Rupture Site
    • Percutaneous Repair

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