[Surgical therapy of Achilles tendon rupture]

From 1980 to 1991, 314 patients with acute rupture of the Achilles tendon were treated operatively in the "Berufsgenossenschaftliche Unfallklinik Tübingen" with suture of the tendon combined with a triceps surae tendon tip-over graft and subsequent cast immobilization for 6 weeks. Analysis of these cases revealed a significant reduction of severe soft tissue complications (3.2%), which were all controllable and a very low rerupture rate (0.3%) compared with the results obtained in the relevant literature. In 223 of these patients postoperative assessment according to the scale of Holz was carried out an average of 8.1 years after injury. The results were assessed as good in 87.4%, satisfactory in 11.2% and poor in 1.4%. Compared with conservative treatment with immobilization these results are significantly better than reported in the literature. The number of patients with Achilles tendon rupture who have received conservative functional treatment with a newly developed boot is still so small that reliable statistical statements are not yet possible. Therefore, operative therapy with an established procedure should still be regarded as the method of choice for treatment of Achilles tendon rupture; the tip-over graft is a valuable complement to the tendon suture.