Mini-open tenorrhaphy of acute achilles tendon ruptures: Medium-term follow-up of 100 cases

Background: The high incidence of soft tissue complications related to open Achilles repair has driven enthusiasm for developing minimally invasive surgical procedures. The Dresden procedure, which reduces wound-healing issues and avoids sural nerve damage, has recently been published and shows good functional results. Objective: To evaluate medium-term clinical results of procedures using the Dresden mini-open technique on acute Achilles tendon ruptures. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was performed on 100 consecutive patients with a mean follow-up of 42.1 months. At followup, the American Orthopaedic Foot and Ankle Society (AOFAS) score, time to return to work and sports, subjective satisfaction, and complications were registered. An isokinetic test was performed on the first 21 patients of this series at 1 year postoperatively. Results: The mean time to return to work was 56.0 days, and the mean time to return to sports was 18.9 weeks. The mean AOFAS score was 97.7; 98% of patients were satisfied. No complications regarding soft tissues and sural nerve damage were reported. Two reruptures and 5 cases of deep venous thrombosis were observed. The isokinetic evaluation showed good recovery of the involved muscles. Conclusion: The excellent functional and satisfaction results, ease of the procedure, and avoidance of sural nerve damage make the mini-open technique a very attractive alternative for acute, spontaneous Achilles tendon ruptures.