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Channel-assisted minimally invasive repair of acute Achilles tendon rupture.

Chen H, Ji X, Zhang Q, Liang X, Tang P - J Orthop Surg Res (2015)

Bottom Line: CAMIR significantly decreased the operative time compared to open repair (17 vs. 56 min, P < 0.0001).Mean scar length was greater in the open repair group (10 vs. 2 cm, P < 0.0001).CAMIR and open repair yielded essentially identical clinical and functional outcomes.

View Article: PubMed Central - PubMed

Affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China.

ABSTRACT

Background: Percutaneous (minimally invasive) suturing is a promising option for Achilles tendon (AT) repair with low rerupture and infection rates. Sural nerve lesions are the major problem to avoid with the technique. A new device was therefore designed for suturing the AT, resulting in channel-assisted minimally invasive repair (CAMIR). The purpose of this study was to compare the clinical and functional outcomes of CAMIR with traditional open techniques.

Method: Eighty two patients with AT rupture were included: 41 for CAMIR, 41 for open repair. All patients followed a standardized rehabilitation protocol. Follow-ups were at 12 and 24 months after surgery. Functional evaluation was based on the clinical American Orthopaedic Foot & Ankle Society score associated with neurologic deficit (sural nerve), calf circumference, range of motion (ROM), and isometric testing.

Results: There was no difference between groups regarding plantar flexor strength, ankle ROM, or calf circumference. CAMIR significantly decreased the operative time compared to open repair (17 vs. 56 min, P < 0.0001). Mean scar length was greater in the open repair group (10 vs. 2 cm, P < 0.0001). There were no wound complications in the CAMIR group but four in the open repair group (P < 0.0001). No deep vein thrombosis, rerupture, or sural nerve injury occurred.

Conclusion: CAMIR and open repair yielded essentially identical clinical and functional outcomes. Sural nerve injuries can be minimized using CAMIR by carefully placing the suture channel with a stab incision and special trocar based on a modified Bunnell suture technique.

No MeSH data available.


Related in: MedlinePlus

Channel-assisted minimally invasive repair system
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Fig1: Channel-assisted minimally invasive repair system

Mentions: The major problem with a percutaneous, minimally invasive technique is sural nerve involvement [7–9]. Some techniques have described measures taken to avoid the risk of nerve injury, such as a modified Achillon technique with the help of an arthroscopic probe [10], endoscopy-assisted percutaneous repair [11], an internal splinting technique [12], and the Mayo needle technique [13–15]. We hypothesized that a channel-assisted minimally invasive repair (CAMIR) that we designed could minimize the possibility of sural nerve injury. The purpose of this study was to compare the clinical and functional outcomes of CAMIR (Fig. 1) with traditional open techniques.Fig. 1


Channel-assisted minimally invasive repair of acute Achilles tendon rupture.

Chen H, Ji X, Zhang Q, Liang X, Tang P - J Orthop Surg Res (2015)

Channel-assisted minimally invasive repair system
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4621853&req=5

Fig1: Channel-assisted minimally invasive repair system
Mentions: The major problem with a percutaneous, minimally invasive technique is sural nerve involvement [7–9]. Some techniques have described measures taken to avoid the risk of nerve injury, such as a modified Achillon technique with the help of an arthroscopic probe [10], endoscopy-assisted percutaneous repair [11], an internal splinting technique [12], and the Mayo needle technique [13–15]. We hypothesized that a channel-assisted minimally invasive repair (CAMIR) that we designed could minimize the possibility of sural nerve injury. The purpose of this study was to compare the clinical and functional outcomes of CAMIR (Fig. 1) with traditional open techniques.Fig. 1

Bottom Line: CAMIR significantly decreased the operative time compared to open repair (17 vs. 56 min, P < 0.0001).Mean scar length was greater in the open repair group (10 vs. 2 cm, P < 0.0001).CAMIR and open repair yielded essentially identical clinical and functional outcomes.

View Article: PubMed Central - PubMed

Affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China.

ABSTRACT

Background: Percutaneous (minimally invasive) suturing is a promising option for Achilles tendon (AT) repair with low rerupture and infection rates. Sural nerve lesions are the major problem to avoid with the technique. A new device was therefore designed for suturing the AT, resulting in channel-assisted minimally invasive repair (CAMIR). The purpose of this study was to compare the clinical and functional outcomes of CAMIR with traditional open techniques.

Method: Eighty two patients with AT rupture were included: 41 for CAMIR, 41 for open repair. All patients followed a standardized rehabilitation protocol. Follow-ups were at 12 and 24 months after surgery. Functional evaluation was based on the clinical American Orthopaedic Foot & Ankle Society score associated with neurologic deficit (sural nerve), calf circumference, range of motion (ROM), and isometric testing.

Results: There was no difference between groups regarding plantar flexor strength, ankle ROM, or calf circumference. CAMIR significantly decreased the operative time compared to open repair (17 vs. 56 min, P < 0.0001). Mean scar length was greater in the open repair group (10 vs. 2 cm, P < 0.0001). There were no wound complications in the CAMIR group but four in the open repair group (P < 0.0001). No deep vein thrombosis, rerupture, or sural nerve injury occurred.

Conclusion: CAMIR and open repair yielded essentially identical clinical and functional outcomes. Sural nerve injuries can be minimized using CAMIR by carefully placing the suture channel with a stab incision and special trocar based on a modified Bunnell suture technique.

No MeSH data available.


Related in: MedlinePlus