Percutaneous Achilles tendon repair with the Dresden instrument. Clinical and MRI evaluation of 90 patients. Issue 2 (February 2020)

• Record Type: Journal Article
• Authors: Joannas, German; Arrondo, Guillermo; Eslava, Santiago; Casola, Leandro; Drago, Juan; Barousse, Rafael; Niño Gomez, Daniel; Amlang, Michael; Rammelt, Stefan
• Is Part Of: Foot and ankle surgery. Volume 26:Issue 2(2020)
• Page Start: 209
• Page End: 217
• Publication Date: 2020-02
• Subjects: Achilles tendon -- Rupture -- Percutaneous -- Repair -- Dresden instrument -- Sural nerve; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2019.02.005
• Languages: English
• ISSNs: 1268-7731

Abstract

Graphical abstract: Highlights: Percutaneous Achilles tendon repair with the Dresden instrument yields excellent clinical results and low complication rates. Modifying the original posteromedial incision carries the risk of wound healing problems and sural nerve damage. MRI at 1 and 6 months reveals an increasingly homogeneous signal in all sequences compatible with physiological tendon healing. Abstract: Background: This study aims at evaluating a substantial number of patients treated with a percutaneous, paratenon preserving technique for Achilles tendon repair using three different incisions with clinical follow-up and magnetic resonance imaging (MRI). Methods: Ninety patients with percutaneous Achilles tendon repair using the Dresden technique for acute rupture were evaluated. Fifteen patients were treated using a central approach, 15 patients using a posterolateral approach and the original posteromedial approach was used in 60 patients. All patients were followed clinically and with MRI after 1 and 6 months post-operatively. Results: Using the standard posteromedial approach no complications were seen. With the central approach 4 (27%) wound healing problems were observed and with the posterolateral approach 2 (13%) sural nerve lesions occurred. One patient (1.1%) had a rerupture. MRI revealed an increased diameter at the rupture site and distal to it as well as an increasingly homogeneous signal over time. Conclusions: Percutaneous Achilles tendon repair with the Dresden technique yields excellent clinical results and a low complication rate. Modification of the original incision is discouraged.