PERCUTANEOUS REPAIR OF ACHILLES-TENDON RUPTURE - IMMOBILIZATION VERSUS FUNCTIONAL POSTOPERATIVE TREATMENT

Between 1987 and 1992, 38 patients with ruptured Achilles tendons were operated on using a standardized microinvasive technique; 30 patients underwent functional postoperative treatment, whereas 18 underwent co nventional cast immobilization, Validated tests and a specially design ed instrument for measuring strength and endurance were used for follo wup examinations, Patients undergoing functional postoperative treatme nt were hospitalized for shorter periods and lost fewer days from work than those in the cast group, Tests of ankle mobility showed more pro nounced limitations of plantar flexion in cast immobilized versus func tionally treated patients, Patients in the cast group also did less we ll on maximal one leg tiptoeing. Percutaneous Achilles tendon repair w ith functional postoperative treatment and early full weightbearing wa s associated with significantly less severe limitations of calf muscle work by the injured leg than postoperative cast immobilization, The r erupture rate was no higher than after cast immobilization, but lower than after open surgical repair or conservative functional treatment a lone, Unlike those undergoing conservative functional treatment, patie nts need not wear special boots at night or be observed by ultrasound studies at regular intervals, Because the procedure can be done on an outpatient basis and because patients lose significantly fewer days fr om work than those immobilized in a cast, cast immobilization after Ac hilles tendon suture repair is no longer justified.