• Hugo Henríquez, Roberto Muñoz, Giovanni Carcuro, and Christian Bastías.
• Foot and Ankle Service, Instituto Traumatológico-University of Chile, Avenida San Martín 771, Santiago, Chile. hhenriquezs@yahoo.com.ar
• Clin. Orthop. Relat. Res. 2012 Apr 1; 470 (4): 998-1003.

BackgroundOpen repair of Achilles tendon rupture has been associated with higher levels of wound complications than those associated with percutaneous repair. However, some studies suggest there are higher rerupture rates and sural nerve injuries with percutaneous repair.Questions/PurposesWe compared the two types of repairs in terms of (1) function (muscle strength, ankle ROM, calf and ankle perimeter, single heel rise tests, and work return), (2) cosmesis (length scar, cosmetic appearance), and (3) complications.Patients And MethodsWe retrospectively reviewed 32 surgically treated patients with Achilles rupture: 17 with percutaneous repair and 15 with open repair. All patients followed a standardized rehabilitation protocol. The minimum followup was 6 months (mean, 18 months; range, 6-48 months).ResultsWe observed similar values of plantar flexor strength, ROM, calf and ankle perimeter, and single heel raising test between the groups. Mean time to return to work was longer for patients who had open versus percutaneous repair (5.6 months versus 2.8 months). Mean scar length was greater in the open repair group (9.5 cm versus 2.9 cm). Cosmetic appearance was better in the percutaneous group. Two wound complications and one rerupture were found in the open repair group. One case of deep venous thrombosis occurred in the percutaneous repair group. All complications occurred before 6 months after surgery. We identified no patients with nerve injury.ConclusionsPercutaneous repair provides function similar to that achieved with open repair, with a better cosmetic appearance, a lower rate of wound complications, and no apparent increase in the risk of rerupture.Level Of EvidenceLevel III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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