Clinical efficacy of ultrasound-guided small incision-assisted modified percutaneous suture in the treatment of acute closed Achilles tendon rupture
Objective To explore the clinical efficacy of ultrasound-guided small incision-assisted modified percutaneous suture in the treatment of acute closed Achilles tendon rupture.Methods This retrospective analysis was conducted on 22 patients with acute closed Achilles tendon rupture who were treated by ultrasound-guided small incision-assisted modified percutaneous suture in the Department of Orthopedics,No.908 Hospital of PLA Joint Lo-gistics Support Force from Apr.2020 to Aug.2023,including 17 cases due to basketball sports,3 due to football sports,and 2 due to 400-m obstacle running.Among the patients,there were 18 males and 4 females aged 20-55(mean 34.5)years,with the median time from injury to surgery being 0.3-2.3 d(mean 1.5).Preoperatively,a portable anesthesia ultrasound machine was used to label the sural nerve.Intraoperatively,a small incision of 2.5-3.0 cm was made on the skin at the severed end.Then the Achilles tendons on both sides were straightened and fixed,which were later sutured using a 2-0 nonabsorbable suture by the weaving method.Postoperatively,the function of the Achilles tendon activity was evaluated using the American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score and Achilles complete rupture score(ATRS),and the rehabilitation effect was evaluated using the Ar-ner-Lindholm criteria.Results Patients were followed up for 9-24(mean 14.7)months.At last follow-up,the AO-FAS-ankle-hindfoot score was excellent in 16 cases,with an average score of 95.6±2.8,and good in the rest 6 ca-ses,with an average score of 84.8±5.1.The total AOFAS ankle-hindfoot score was 92.6±6.0,and the ATRS was 91.9±7.3.The Arner-Lindholm criteria defined 16 cases as excellent and the rest 6 as good.No poor results were reported.All patients had good wound healing,without any skin edge necrosis,Achilles tendon adhesion,incision in-fection or sural nerve injuries.Until the end of follow-up,there was no recurrence of rupture,and patients obtained their pre-injury living and physical activity levels.The MRI exam also showed good continuity of the Achilles ten-don.Conclusion Ultrasound-guided small incision-assisted modified percutaneous suture is effective in managing Achilles tendon ruptures,which is simple and minimally invasive,with quick recovery and few complications.
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