Achilles Tendon Rupture

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Abstract
The two objectives of surgical treatment of closed Achilles tendon ruptures in physically active patients are the restoration of the musculotendinous structure to its proper length and tendon healing. However, faulty wound healing and postoperative tendon rupture are just two complications that can occur. We devel oped a new surgical procedure that permits better tendon repair by using three specially constructed barbed wire hooks and Aldam's cutaneous approach. The integrity of the suture permits an immediate con trolled movement of the ankle with a postoperative orthopaedic brace. Weightbearing can be started after 2 months. We operated on 78 physically active patients with 78 closed Achilles tendon ruptures between February 1989 and November 1994. We reexamined 71 patients after an average of 24.5 months. All the tendons had healed completely without wound compli cations. Early assisted movement of the ankle also helped avoid the need for functional rehabilitation. This technique is easily performed, and the immediate movement of the foot and ankle helps the remodeling of scar tissue, at the same time inhibiting the formation of skin adherences that can later interfere with full movement of the joint.

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