Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study.

A comparative study between percutaneous repair and open surgical repair of acute spontaneous Achilles tendon ruptures in young athletic patients is presented. Twenty-seven patients with acute Achilles ruptures were evaluated objectively and with subjective questionnaires. Fifteen of the patients were treated by reconstruction with a gastrocsoleus fascial graft (followup, 4.6 years) and 12 treated by percutaneous repair (followup, 1.8 years). Subjectively, both groups were very satisfied with the results of their treatment. Cybex II dynamometer measuring strength, power, and endurance revealed no statistical significant differences between groups, even in light of the shorter followup of the percutaneous group. The percutaneous repairs demonstrated significantly more symmetry in injured/uninjured tendon size than did the open surgical repairs. Two reruptures occurred in the percutaneous group. No other complications were noted. After evaluation of both subjective and objective data we recommend percutaneous repair in the recreational athlete and in patients concerned with cosmesis. Open repair is recommended for all high-caliber athletes who cannot afford any chance of rerupture.