A New Surgical Technique for Achilles Tendon Rupture: A Retrospective Study of 18 Cases.

Abstract

Background: The optimal treatment for acute closed Achilles tendon rupture (ATR) is still controversial. Many grassroots hospitals lack advanced equipment to perform effective minimally invasive surgeries, and open surgeries increase the incidence of complications. Therefore, we have developed a new technique specifically for grassroots hospitals. It involves using oval forceps-assisted minimally invasive suture bridge technology to treat acute closed Achilles tendon ruptures. This technique is easy to perform and has shown good clinical outcomes.

Methods: We reviewed the therapeutic effectiveness of using oval forceps-assisted minimally invasive suture bridge technique in the treatment of 18 patients with ATR. All patients were followed up for a minimum of 12 months. Preoperative and postoperative follow-up data were reviewed to analyze the results and evaluate the surgical outcomes.

Results: The patients were followed up for 12-16 months [( $13.9\pm 1.6$ ) months]. There was no statistically significant difference in the ankle joint visual analog scale (VAS) scores at 3, 6, and 12 months postoperatively ( $P>$ 0.05). However, there was a statistically significant increase in ankle joint active range of motion(AROM) at 3, 6, and 12 months postoperatively ( $P<$ 0.05). At the same time, there was no statistically significant difference in AROM between the healthy side and the affected side at 12 months postoperatively. The American Orthopaedic Foot & Ankle Society(AOFAS) scores and Achilles Tendon Total Rupture Score (ATRS) showed a gradual improvement at 3, 6, and 12 months postoperatively, with statistical significance ( $P<$ 0.05). All surgical incisions healed well without complications such as injury to the sural nerve or incision infection. Three patients experienced pain at the site of ATR at 3 months postoperatively, which resolved after a 2-week course of oral nonsteroidal anti-inflammatory drugs (NSAIDs). One patient experienced transient pain at the Achilles tendon insertion point after 6 months of activity, which disappeared after a 2-week course of oral NSAIDs.

Conclusion: The use of oval forceps-assisted suture bridge technique for the treatment of acute closed ATR is characterized by its small incision, simple operation, and minimal complications, meeting the requirements for early functional rehabilitation of patients. For grassroots hospitals that receive a large number of patients, the oval forceps-assisted suture bridge technique is a surgical method worth popularizing.