Background/Aim. Today there are controversies about
searching for the ideal surgical method (conservatively with
plaster cast, with open and percutaneous tenorrhaphy) for
repairing a ruptured Achilles tendon. The aim of this study
study was to examine the results of treating Achilles tendon
ruptures in patients by using the following methods: percutaneous suturing, open surgery technique and non-surgical
treatment by plaster cast immobilisation. Methods. Forty
two patients treated at our facility in the period August 2003
– September 2010 for Achilles tendon ruptures were included in the study. They were operated on by using different orthopedic procedures (percutaneous reconstruction of
the Achilles tendon, open surgery, plaster cast only) and two
anaesthesia technique (spinal aneasthesia and local infiltrational anaesthesia). The following parameters were monitored after interventions performed and compared: duration
of hospital stay, postsurgical complications, incidence of the
reruptures of the Achilles tendon and time for full leg functionality. Results. The patients sustained their respective injuries in the following manner: 8 of them while pursuing
sports activities, 24 while pursuing recreational activities, 4 at
workplace, 4 while performing everyday activities, and 2 of
the patients did not know how they had sustained their injuries. The average age of the patients was 40.5, with 37 (88%)
men and 5 (12%) women. Surgeries were performed under
spinal anaesthesia in 29 (69%) patients, and in 5 (12%) patients tenorrhaphy was performed under local anaesthesia.
Anaesthesia was not used in 8 (19%) patients treated with
plaster cast. We performed percutaneous reconstruction of
the Achilles tendon in 19 (45%) patients. A total of 14 (33%)
patients were treated under spinal anaesthesia, and 5 (11.9%)
under local infiltrational anaesthesia with 2% xylocain. We
treated 15 (36%) patients with open surgery. The patients
treated conservatively stayed in hospital on average for up to
5 hours. Those who underwent an percutaneous surgery
stayed 2 days and those who underwent an open surgery
stayed 9 days. A total of 28 (66%) patients from the given series experienced no complications. The patients treated with
open surgical reconstruction experienced skin complications
ranging from inflammatory changes on the skin in 6 (14%)
patients to dehiscence and skin necrosis in 3 (7%). The 5
(11.9%) patients whose ruptured Achilles tendon was treated
percutaneously experienced temporary redness and delayed
healing of the incision(s) longer than 5 mm. A total of 3
(7%) patients treated with open surgery and 1 (2%) patient
treated with percutaneous tenorrhaphy had temporary peroneal nerve prolapses. A total of 7 (16.6%) patients had reruptures: 4 were treated with plaster cast, 2 underwent open
surgery, and 1 was treated percutaneously. Out of the 8 patients who were treated with plaster cast, 4 sustained reruptures and 3 of the 4 had diabetes. Conclusion. Surgical
treatment, percutaneous tenorrhaphy, performed in a small
operating theatre under local anaesthesia, should be preferred in cases of fresh ruptures of the Achilles tendon.
