END-TO-END OPERATIVE REPAIR OF ACHILLES-TENDON RUPTURE

We present the long-term results of operative repair in 23 consecutive patients with Achilles tendon ruptures, treated between 1984 and 1991 , to evaluate our treatment method and determine the clinical causes o f rupture. Fifty-four percent of ruptures occurred in people in their 30s; 90% occurred during participation in acceleration-deceleration sp orts. All but three patients were treated within 1 week of injury with open, operative, end-to-end repair of the Achilles tendon. The remain ing three patients were treated more than 3 weeks after injury. All pa tients followed a standard postoperative regimen. Followup averaged 3. 6 years (range, 1 to 7.5). Seventeen patients were available for Cybex analysis, and the remaining patients were interviewed personally or b y telephone. Subjectively, patients were very satisfied with the resul ts of treatment. Objectively, physical examination and Cybex testing t o measure strength and endurance revealed results somewhat better than those previously reported with operative repair. No patient experienc ed a rerupture, although one attenuated repair was noted 9 months post operatively. Only two minor wound problems were recorded. Long-term re sults revealed near-normal function when comparing the injured side wi th the uninjured side. Ninety-two percent of patients returned fully t o their preinjury levels of activity.