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Treatment of Achilles Tendon Rupture with Absorbable Suture

흡수성 봉합사를 이용한 아킬레스건 파열의 치료

  • Kang, Chan (Department of Orthopaedic Surgery, Chungnam National University School of Medicine) ;
  • Hwang, Deuk-Soo (Department of Orthopaedic Surgery, Chungnam National University School of Medicine) ;
  • Hwang, Jung-Mo (Department of Orthopaedic Surgery, Chungnam National University School of Medicine) ;
  • Song, Jae-Hwang (Department of Orthopaedic Surgery, Chungnam National University School of Medicine) ;
  • Shin, Byung-Kon (Department of Orthopaedic Surgery, Chungnam National University School of Medicine) ;
  • Park, Jong-Hwa (Department of Orthopaedic Surgery, Chungnam National University School of Medicine)
  • 강찬 (충남대학교 의과대학 정형외과학교실) ;
  • 황득수 (충남대학교 의과대학 정형외과학교실) ;
  • 황정모 (충남대학교 의과대학 정형외과학교실) ;
  • 송재황 (충남대학교 의과대학 정형외과학교실) ;
  • 신병건 (충남대학교 의과대학 정형외과학교실) ;
  • 박종화 (충남대학교 의과대학 정형외과학교실)
  • Received : 2014.04.28
  • Accepted : 2014.08.12
  • Published : 2014.09.15

Abstract

Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.

Keywords

References

  1. Hwang DS, Lee WS, Kim KC. Surgical treatment of ruptured Achilles tendon: end-to-end suture and paratendinous wrapping. J Korean Orthop Soc Sports. 2002;1:138-42.
  2. Kang C. Ultrasound-guided regional nerve block in lower extremity. J Korean Orthop Ultrasound Soc. 2012;1:50-9.
  3. Krackow KA, Thomas SC, Jones LC. A new stitch for ligament-tendon fixation. Brief note. J Bone Joint Surg Am. 1986;68:764-6.
  4. Ihn JC, Park BC, Kyung HS, Kim SY, Shin SH. Surgical treatment of the closed complete rupture of Achilles tendon. J Korean Orthop Assoc. 1997;32:1681-6.
  5. Singer AJ, Thode HC Jr. Determination of the minimal clinically significant difference on a patient visual analog satisfaction scale. Acad Emerg Med. 1998;5:1007-11.
  6. Park IH, Lee KB, Song KW, Lee JY, Song YS. Surgical repair of Achilles tendon ruptures: 3 tissue bundle technique. J Korean Orthop Assoc. 1990;25:1406-13.
  7. Lavine LS, Karas S, Warren RF. Two-pin technic for Achilles tendon repair. Clin Orthop Relat Res. 1965;40:137-8.
  8. Kim HN, Park KH, Park YW. Treatment of acute Achilles tendon rupture using Krackow suture technique. J Korean Foot Ankle Soc. 2009;13:34-9.
  9. Lagergren C, Lindholm A. Vascular distribution in the Achilles tendon; an angiographic and microangiographic study. Acta Chir Scand. 1959;116:491-5.
  10. Smart GW, Taunton JE, Clement DB. Achilles tendon disorders in runners--a review. Med Sci Sports Exerc. 1980;12:231-43.
  11. Kim DY, Kim SB, Heo YM, Lee JB, Lim JW, Oh HT. Surgical treatment of the ruptured achilles tendon: a comparative study between percutaneous and open repair. J Korean Foot Ankle Soc. 2011;15:79-85.
  12. Saxena A, Maffulli N, Nguyen A, Li A. Wound complications from surgeries pertaining to the Achilles tendon: an analysis of 219 surgeries. J Am Podiatr Med Assoc. 2008;98:95-101.
  13. Winter E, Weise K, Weller S, Ambacher T. Surgical repair of Achilles tendon rupture. Comparison of surgical with conservative treatment. Arch Orthop Trauma Surg. 1998;117:364-7.
  14. Henr quez H, Mu oz R, Carcuro G, Bast as C. Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res. 2012;470:998-1003.
  15. Carmont MR, Heaver C, Pradhan A, Mei-Dan O, Silbernagel KG. Surgical repair of the ruptured Achilles tendon: the cost-effectiveness of open versus percutaneous repair. Knee Surg Sports Traumatol Arthrosc. 2013;21:1361-8.
  16. Shaieb MD, Singer DI. Tensile strengths of various suture techniques. J Hand Surg Br. 1997;22:764-7.
  17. Viinikainen A, G ransson H, Ryh nen J. Primary flexor tendon repair techniques. Scand J Surg. 2008;97:333-40.
  18. Bourne RB, Bitar H, Andreae PR, Martin LM, Finlay JB, Marquis F. In-vivo comparison of four absorbable sutures: Vicryl, Dexon Plus, Maxon and PDS. Can J Surg. 1988;31:43-5.
  19. Ashammakhi N, Gonzalez AM, T rm l P, Jackson IT. New resorbable bone fixation. Biomaterials in craniomaxillofacial surgery: present and future. Eur J Plast Surg. 2004;26:383-90.
  20. Zhou Y, Guthrie G, Chuang A, Faro JP, Ali V. Unidirectional barbed suture versus interrupted vicryl suture in vaginal cuff healing during robotic-assisted laparoscopic hysterectomy. J Robotic Surg. 2014;8:201-5.

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  1. Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair vol.53, pp.6, 2018, https://doi.org/10.4055/jkoa.2018.53.6.522
  2. A comparative study of innovative percutaneous repair and open repair for acute Achilles tendon rupture: Innovative usage of intraoperative ultrasonography vol.28, pp.1, 2014, https://doi.org/10.1177/2309499020910274