Double Transverse Mini-Incision Repair for Proximal Achilles Tendon Tears

Recent literature showing equivalent outcomes for surgical and nonoperative management of Achilles tendon ruptures emphasizes the importance of proper indications for surgical repair. Various techniques for tendon repair via reapproximation of the torn ends have been described, such as open, mini-open, and minimally invasive, each with their own advantages and disadvantages. This technique note describes a modified double transverse mini-open repair procedure for proximal Achilles tendon tears that addresses the limited mobility of the distal stump seen with proximal tears, allowing for reapproximation and high healing rate. Advantages of this technique include simplicity, high reproducibility, and limited disruption of the posterior watershed region of the superficial skin and soft tissue overlying the tendon. This decreases the risk of wound complications that can lead to surgical site infections and skin-tendon adhesion.