Achilles tendon repair surgery is used when there has been a partial or complete tear or rupture of the Achilles tendon and other treatments are not appropriate. This type of surgery is designed to reconnect the Achilles tendon if a tear occurs. The two different methods of performing Achilles tendon repair surgery are open surgery, which involves one long incision down the back of the injured leg, and percutaneous surgery, which involves making multiple smaller incisions to complete the procedure instead of one large one.
The Achilles tendon is the largest tendon in the human body, and is a band of fibrous tissue situated at the back of the ankle. This tendon connects the calf muscle to the calcaneus, or heel bone. This tendon is vital for walking, running, and jumping.
An Achilles tendon rupture is an injury involving a partial or complete tear through the tendon, most often about 2 inches (5 cm) above the heel. An injury of this nature can occur during physical activities, or during a fall, when the forces exerted on the tendon are too great, causing a rupture. An Achilles tendon rupture is often very painful. At the time of injury, sudden onset of severe pain is common, as is an audible popping sound. Pain, swelling, bruising, stiffness, and lack of mobility also occur.
Open Achilles tendon repair surgery involves a long incision made in the back of the injured leg to expose the ruptured tendon. The ruptured ends of the tendon are cleaned and any dead or damaged tissue is removed. The ends of the tendon are then repositioned in an anatomically correct placement and sutured with a tough, non-absorbable suture. Care should be taken not to over or under tighten the tendon at this point; a loose tendon would result in weakness and permanent loss of strength, while and tight tendon would greatly reduce mobility and flexibility, as well as being at a higher risk of rerupture.
Percutaneous Achilles tendon repair surgery is a procedure that uses multiple smaller incisions in the injured leg. The doctor uses these smaller incisions to reconnect the tendon. The risk of infection appears to be slightly less than that of open procedures, but the risk of damage to other important anatomical components of the leg, such as the sural nerve, increases significantly.
If an Achilles rupture, either partial or complete, is suspected, it is vital that the sufferer immobilize the ankle immediately and seek medical attention. If left untreated, this injury may result in a permanent lack of mobility and strength. When the injured ankle is not immobilized, there is a risk of further injury and complications.