Percutaneous Repair of Acute Achilles Tendon Ruptures: The Maffulli Procedure

  • Nicola MaffulliEmail author
  • Francesco Oliva
  • Mario Ronga


The Achilles tendon (AT) is the strongest tendon in the human body, but despite its strength, is the most frequently ruptured tendon in the body. Ruptures usually occur between 2 and 6 cm of its insertion into the superior surface of the calcaneus, a relatively hypovascular area [7, 17]. The major blood supply to tendons is from the mesotendon, and the largest supply is from the anterior mesentery [2]. The tendon is at the greatest risk of rupture when it is obliquely loaded, the muscle is contracting maximally, and tendon length is short [12]. This usually occurs as a result of pushing off with the foot against resistance, and occurs most frequently in males in their fourth decade.


Achilles Tendon Sural Nerve Transverse Incision Percutaneous Technique Stab Incision 
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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Nicola Maffulli
    • 1
    • 2
    Email author
  • Francesco Oliva
    • 3
  • Mario Ronga
    • 4
  1. 1.Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End HospitalQueen Mary University of LondonLondonUK
  2. 2.Department of Trauma and Orthopaedic SurgeryKeele University School of Medicine, University Hospital of North StaffordshireStoke-on-Trent, StaffordshireUK
  3. 3.Department of Trauma and Orthopaedic SurgeryUniversity’ of Rome “Tor Vergata”RomeItaly
  4. 4.Department of Orthopaedic and Trauma SurgeryUniversity of InsubriaVareseItaly

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