[Repair of acute Achilles tendon rupture. Comparative study of two surgical techniques]

The treatment of Achilles tendon rupture has been controversial, and attempts are made to attenuate the complications arising from invasive procedures with minimally invasive techniques. This paper is a comparison between the results of Lynn's traditional open technique and those of minimally invasive surgery assisted with the Achillon instrument guide.

A prospective, randomized study was carried out in fifty-six patients with acute rupture of the Achilles tendon. Twenty-eight of them underwent surgery with Lynn's technique and 28 underwent minimally-invasive surgery assisted with a mechanical guide. Patients were assessed at postoperative weeks 4, 6, 8, 10 and 16. They were examined for pain, muscle strength, presence or absence of Thomas sign, Merkel scale, ranges of motion, degree of amyotrophy, time to healing, degree of functional recovery, and complications. Data analysis was done with central trend measurements and nonparametric analyses.

The following were reported for Lynn's technique (LT) and the minimally invasive approach (MI): Mobility in extension: (LT) 40.3 +/- 0.59 degrees vs. (MI) 50.0 +/- 0.42 (p < 0.01); flexion: (LT) 13.9 +/- 0.12 degrees vs. (MI) 18.2 +/- 18.2 degrees (p < 0.01); amyotrophy: (LT) 2.9 +/- 0.09 cm vs. (MI) 1.5 +/- 0.13 (p < 0.01); time to healing: (LT) 9.0 +/- 0.13 vs. (MI) 6.1 +/- 0.09 weeks (p = 0.01); return to work: (LT) 9 weeks vs. (MI) 6 weeks. Postoperative complications were 19 for LT and 1 for MI.

The MI approach had statistically significant advantages over Lynn's technique, which we attribute to a lesser tissue and neurovascular trauma.