CME OnDemand: 2022 AOFAS Annual Meeting-Surgical Repair of the Achilles Tendon using the Three Transverse Incision Technique

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The document describes a surgical technique for repairing acute Achilles tendon rupture using the three transverse incision method. The study was conducted by the Department of Orthopedics and Traumatology at the Federal University of São Paulo. The aim of the study was to demonstrate the benefits of this technique, which has shown low postoperative complications and does not require special materials.<br /><br />The main indications for using this technique are patients with Achilles tendon rupture within three weeks of the injury and with the lesion located in the middle third of the tendon. The surgical procedure involves making three transverse incisions to expose and suture the proximal and distal stumps of the tendon. The foot is immobilized in plantar flexion for one week and then gradually allowed weight-bearing with the help of crutches.<br /><br />The study reported that no re-ruptures, sural nerve damage, or deep infections occurred in the 24 patients who underwent this surgical technique. There was only one case of superficial infection, which was quickly treated with oral antibiotics. However, due to the low number of patients who completed the 48-week follow-up, it is difficult to make a comparison with other techniques described in the literature.<br /><br />The document discusses the ongoing debate between conservative and surgical treatments for Achilles tendon rupture. While surgical treatment is often recommended for high-performance athletes due to faster rehabilitation, there is growing evidence that surgical and conservative treatments yield similar results in non-athletes. The study also highlights the importance of minimizing postoperative complications, such as wound problems and sural nerve damage, through minimally invasive techniques.<br /><br />In conclusion, the study suggests that further research is needed to determine the best treatment approach for acute Achilles tendon rupture. Nevertheless, the three transverse incision technique described in the document has shown promising results in terms of fewer complications and can be performed in any orthopedic service.

Asset Subtitle

Caio A. Araujo, Eduardo S. Maciel, Nacime SB Mansur, MD

Keywords

surgical technique

Achilles tendon rupture

three transverse incision method

postoperative complications

middle third of the tendon

immobilized in plantar flexion

weight-bearing with crutches

re-ruptures

sural nerve damage

conservative treatments