Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 16, Issue 2, pp 199–203 | Cite as

Modified percutaneous repair of ruptured Achilles tendon

  • Michael R. CarmontEmail author
  • Nicola Maffulli
Sports Medicine


Percutaneous repair of the Achilles tendon is now well established. Sural nerve injury is one of the commonest complications following this method of repair. We present our current method of percutaneous repair which permits a less invasive approach to the tendon, accurate opposition of the tendon ends, and minimises the chance of sural nerve injury.


Percutaneous Achilles Tendon Repair 



We would like to thank the Department of Medical Illustration at the University Hospital of North Staffordshire for their assistance with this manuscript. We would also like to thank Mr. Dave Harris QA Manager at Tyco healthcare for his provision of the technical data on the Maxon suture. The patient has given their written consent for the photographic images used for publication. The authors have received no funding for the study.

Competing interests

The authors can confirm that there are no competing interests. We thank Sportsmed (UK) for the support given.


  1. 1.
    Barrie KA, Tomak SL, Cholewick I, Wolffe SW (2000) The role of multiple strands and locking sutures on gap formation of flexor tendon repairs during cyclical loading. J Hand Surg (Am) 25(4):714–720CrossRefGoogle Scholar
  2. 2.
    Buchgraber A, Passler HH (1997) Percutaneous repair of Achilles tendon rupture. Clin Orth Rel Res 341:113–122Google Scholar
  3. 3.
    Cretnik A, Kosanovic M, Smrkolj V (2004) Percutaneous suturing of the ruptured Achilles tendon under local anaesthesia. J Foot Ankle Surg 43(2):72–81PubMedCrossRefGoogle Scholar
  4. 4.
    Flavin R, Gibney R, O’Rouke SK (2006) A clinical test to avoid sural nerve injuries in percutaneous Achilles tendon repairs. Presented at The British Orthopaedic Foot and Ankle Society, 15–17 November 2006, CreweGoogle Scholar
  5. 5.
    Kessler I, Nissim F (1969) Primary repair without immobilisation of flexor tendon division within the digital sheath: an experimental and clinical study. Acta Orthop Scand 40:587–601PubMedCrossRefGoogle Scholar
  6. 6.
    Ma GWC, Griffith TG (1977) Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop 128:247–255PubMedGoogle Scholar
  7. 7.
    Maes R, Copin G, Averous C (2006) Is percutaneous repair of the Achilles tendon a safe technique? A study of 124 cases. Acta Orthop Belg 72(2):179–183PubMedGoogle Scholar
  8. 8.
    Majewski M, Rohrbach M, Czaja S, Ochsner P (2006) Avoiding sural nerve injuries during percutaneous Achilles tendon repair. Am J Sports Med 34(5):793–798PubMedCrossRefGoogle Scholar
  9. 9.
    Matles AL (1975) Rupture of the tendo Achilles. Another diagnostic sign. Bull Hosp Joint Dis 36(1):48–51Google Scholar
  10. 10.
    McClelland D, Maffulli N (2002) Percutaneous repair of the ruptured Achilles tendon. J R Coll Surg Edinb 47:613–618PubMedGoogle Scholar
  11. 11.
    Newport Ml, Williams CD (1992) Biomechanical characteristics of extensor tendon suture techniques. J Hand Surg (Am) 17:1117–1123CrossRefGoogle Scholar
  12. 12.
    Simmonds FA (1957) The diagnosis of the ruptured Achilles tendon. Practitioner 179:56–58PubMedGoogle Scholar
  13. 13.
    Tang K, Thermann H, Dai G, Chen G, Guo L, Yang L (2007) Arthroscopically assisted percutaneous repair of fresh closed Achilles tendon rupture by Kessler’s suture. Am J Sports Med 35(4):589–596PubMedCrossRefGoogle Scholar
  14. 14.
    Thermann H, Tibesku CO, Mastrokalos DS, Passler HH (2001) Endoscopically assisted percutaneous Achilles tendon suture. Foot Ankle Int 22(2):158–160PubMedGoogle Scholar
  15. 15.
    Thordarson DB (2006) Immediate full weight bearingmobilization was better than immobilization after operative repair of ruptured Achilles tendon. J Bone J Surg 88-A(8):1894CrossRefGoogle Scholar
  16. 16.
    Waldram M (2003) Peripheral nerve injuries. Trauma 5:79–96CrossRefGoogle Scholar
  17. 17.
    Webb JM, Bannister GC (1999) Percutaneous repair of the ruptured tendon Achilles. J Bone Joint Surg 81-B:877–880CrossRefGoogle Scholar
  18. 18.
    Webb J, Moorjani N, Radford M (2000) Anatomy of the sural nerve and its relation to the Achilles tendon. Foot Ankle Int 21(6):475–477PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of Trauma and Orthopaedics, Hartshill Orthopaedic Surgical UnitUniversity Hospital of North Staffordshire, Keele University School of MedicineStoke on TrentUK

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