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European Journal of Trauma and Emergency Surgery

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Open Access 11-03-2022 | Achilles Tendon Rupture | Original Article

Intra-operative ultrasound: does it improve the results of percutaneous repair of acute Achilles tendon rupture?

Author: Ahmed Mohamed Samy

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

Abstract

Purpose

Percutaneous repair is a good option for acute Achilles tendon rupture. Although it overcomes the complications of open technique, it carries the risk of sural nerve injury and inadequate repair. In this study, we explore if the use of intra-operative ultrasound with percutaneous technique has any advantageous effect on final results of repair.

Methods

This is a prospective randomized study done between May 2014 and December 2020. It included 91 patients with complete acute Achilles tendon rupture distributed in 2 groups with homogenous clinical and demographic data. Group A (n = 47) included those managed by percutaneous repair with assistant of an intra-operative ultrasound. Group B (n = 44) included those done without the assistant of ultrasound. Post-operative evaluation was done clinically by the American Orthopedic Foot and Ankle Society score, calf muscle circumference and single heel rise test and radiologically by Magnetic Resonance Image.

Results

Patients of both groups reported continuous improvement of the American Orthopedic Foot and Ankle Society score with time. However, patient of group A recorded better functional outcome score at 3 months postoperatively. We recorded longer operative time in group A than those in group B. Continuous improvement of maximum calf circumference was observed in both groups. Satisfactory healing was noticed to happen faster in patients of group A than those of group B. We recorded two cases of re-rupture and two cases of sural nerve injury in group B with no reported complication in group A.

Conclusion

The use of an intra-operative ultrasound with percutaneous repair of acute rupture of Achilles tendon can improve the quality of repair as evidenced by quicker satisfactory healing and earlier regain of activity. Also, it can help in proper localization of sural nerve in relation to lateral edge of Achilles tendon.

Trial registration

Clinical Trials.gov Identifier: NCT04935281.

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Title: Intra-operative ultrasound: does it improve the results of percutaneous repair of acute Achilles tendon rupture?
Author: Ahmed Mohamed Samy
Publication date: 11-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: Achilles Tendon Rupture
Nerve Injury
Ultrasound
Ultrasound
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01926-x

At a glance: The STEP trials

Springer Medicine

Intra-operative ultrasound: does it improve the results of percutaneous repair of acute Achilles tendon rupture?

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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