Background:

Repair of acute Achilles tendon rupture using the Achillon device is a representative mini-open repair technique; however, the limitations of this technique include the need for special instruments and decreased repair strength. A modified mini-open repair using ring forceps might overcome these limitations.

Purpose:

To compare the Achillon device with ring forceps in mini-open repairs of acute Achilles tendon rupture.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Fifty patients (41 men and 9 women) with acute Achilles tendon rupture on 1 foot were consecutively treated using mini-open repair techniques. The first 20 patients were treated using the Achillon device (Achillon group), and the subsequent 30 were treated using a ring forceps (forceps group). Clinical, functional, and isokinetic results and postoperative complications were compared between the groups at the last follow-up. Clinical evaluations were performed using the AOFAS (American Orthopaedic Foot and Ankle Society) score, Achilles Tendon Total Rupture Score, length of incision, and operation time. Functional evaluations included active range of motion of the ankle joint, maximum calf circumference, hopping test, and single-limb heel rise (SLHR). Isokinetic evaluations were performed using the isokinetic test for ankle plantar flexion.

Results:

The AOFAS score (P = .669), Achilles Tendon Total Rupture Score (P = .753), and length of incision (P = .305) were not significantly different between the groups (mean ± SD, 90.1 ± 8.7, 88.3 ± 9.9, and 2.7 ± 0.3 cm in the Achillon group vs 92.2 ± 9.4, 89.9 ± 10.9, and 2.5 ± 0.4 cm in the forceps group, respectively). Operation times in the Achillon group were significantly shorter than those in the forceps group (41.4 ± 9.6 vs 62.8 ± 14.1 minutes, P < .001). The maximum height of the SLHR (P = .042) and the number of SLHRs (P = .043) in the forceps group (79.7% ± 7.4% and 72.9% ± 10.2%) were significantly greater than those in the Achillon group (75.3% ± 7.1% and 66.7% ± 11.0%). No significant differences were detected between the groups in mean peak torques for plantar flexion at angular speeds of 30 deg/s (P = .185) and 120 deg/s (P = .271). There was no significant difference in the occurrence of postoperative complications between the groups (P = .093).

Conclusion:

The ring forceps technique is comparable to the Achillon technique with respect to clinical, functional, and isokinetic results and postoperative complications. Given that no special instrument is required, the ring forceps technique could be a better option for acute Achilles tendon rupture repair.

中文翻译：

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急性跟腱断裂的微型开放修复：环钳与跟腱装置

背景：

使用跟腱装置修复急性跟腱断裂是一种代表性的微型开放修复技术；然而，这种技术的局限性包括需要特殊仪器和降低修复强度。使用环钳进行改良的微型开放修复可能会克服这些限制。

目的：

比较 Achillon 装置与环形钳在急性跟腱断裂的微型开放修复中的应用。

学习规划：

队列研究；证据等级，3。

方法：

50 名患者（41 名男性和 9 名女性）的 1 只脚发生急性跟腱断裂，使用微型开放修复技术进行了连续治疗。前 20 名患者使用 Achillon 装置（Achillon 组）进行治疗，随后的 30 名患者使用环形钳（钳组）进行治疗。在最后一次随访时比较两组之间的临床、功能和等速结果以及术后并发症。使用 AOFAS（美国矫形足踝协会）评分、跟腱总断裂评分、切口长度和手术时间进行临床评估。功能评估包括踝关节的活动范围、最大小腿周长、跳跃测试和单肢足跟抬高 (SLHR)。使用踝跖屈的等速试验进行等速评估。

结果：

AOFAS 评分 ( P = .669)、跟腱总断裂评分 ( P = .753) 和切口长度 ( P = .305) 在各组之间没有显着差异（平均值 ± SD、90.1 ± 8.7、88.3 ± Achillon 组为 9.9 和 2.7 ± 0.3 cm，而镊子组分别为 92.2 ± 9.4、89.9 ± 10.9 和 2.5 ± 0.4 cm）。Achillon 组的手术时间明显短于钳子组（41.4 ± 9.6 对 62.8 ± 14.1 分钟，P < .001）。SLHR的最大高度 ( P = .042) 和 SLHR 的数量 ( P= .043) 钳组（79.7% ± 7.4% 和 72.9% ± 10.2%）显着高于 Achillon 组（75.3% ± 7.1% 和 66.7% ± 11.0%）。在角速度为 30 度/秒 ( P = .185) 和 120 度/秒 ( P = .271) 时，两组之间在跖屈的平均峰值扭矩方面没有检测到显着差异。两组间术后并发症的发生率没有显着差异（P = .093）。

结论：

环钳技术在临床、功能和等速结果以及术后并发症方面与 Achillon 技术相当。鉴于不需要特殊仪器，环钳技术可能是急性跟腱断裂修复的更好选择。