A prospective randomized controlled trial comparing open and percutaneous repair of closed ruptured Achilles tendons was performed over a period of 30 months. 66 patients from 7 district general hospitals were entered into the study with 33 patients randomized into each group. A modification of the technique described by Ma and Griffith was used in the percutaneous group and a Kessler suture supplemented with interrupted sutures was used in the open group. Patients were followed up for a minimum of 6 months. The mean age was 38.5 years (26 to 53 years). 40 patients were male and 26 female. After the rupturing event but prior to surgery, it was noted that 7 patients had paresthesia in the territory of the sural nerve. The mean duration of immobilization was 12.4 weeks (10 to 14). The complications in the open group included 7 wound infections (21%), 2 adhesions (6%) and 2 cases of re-rupture (6%). In the percutaneous group there were 3 cases of wound puckering (9%), one re-rupture (3%) and one case with persistent paresthesia in the sural nerve territory (3%). The difference in infective wound complications between the 2 groups was statistically significant (Fisher's exact test P = 0.01). Percutaneous repair is advocated on the basis of the low rate of complications and improved cosmetic appearance.
Copyright remains with the authors and publisher.
A prospective randomized controlled trial comparing open and percutaneous repair of closed ruptured Achilles tendons was performed over a period of 30 months. 66 patients from 7 district general hospitals were entered into the study with 33 patients randomized into each group. A modification of the technique described by Ma and Griffith was used in the percutaneous group and a Kessler suture supplemented with interrupted sutures was used in the open group. Patients were followed up for a minimum of 6 months. The mean age was 38.5 years (26 to 53 years). 40 patients were male and 26 female. After the rupturing event but prior to surgery, it was noted that 7 patients had paresthesia in the territory of the sural nerve. The mean duration of immobilization was 12.4 weeks (10 to 14). The complications in the open group included 7 wound infections (21%), 2 adhesions (6%) and 2 cases of re-rupture (6%). In the percutaneous group there were 3 cases of wound puckering (9%), one re-rupture (3%) and one case with persistent paresthesia in the sural nerve territory (3%). The difference in infective wound complications between the 2 groups was statistically significant (Fisher's exact test P = 0.01). Percutaneous repair is advocated on the basis of the low rate of complications and improved cosmetic appearance.
Copyright remains with the authors and publisher.