Surgical Repair of Achilles Tendon Ruptures: 3 Tissue Bundle Technique

Since Pare's first report on Achilles tendon rupture in 1575, many authors have presented numerous operative and nonoperative methods for its treatment. Numerous controversies following its treatment have been concerned with the selection of its treatment method, which could minimizing the complications and enable early ambulation. We analysed 98 cases of Achilles tendon rupture in adults which were treated by direct repair, three-tissue bundle technique, or Plantaris/Peroneus augmentation repair for 3(1)/4 years from Oct. 1986 to Dec. 1989. We compared with types of cast after operation, periods for immobilization, and ankle motion of dorsiflexion at postoperative 6 weeks & long-term follow up. The results obtained from this study were as follows; l. After repair by three-tissue bundle technique, a short leg cast was applied, and then a weight bearing was started at postoperative 3 weeks. It can be demonstrated to shorten hospitalization and early ambulation when compared to other surgical techinques. 2. The patients who were repaired with the three-tissue bundle techinque averaged 12.5° dorsiflexion at the time of cast removal at postoperative 6 weeks, compared to 0°, 1° plantar flexion, and 4.4° plantar flexion with other techniques. The former group was significantly better than that of the latter group, and these differences were not present at long-term follow up. 3. On follow up period, discoverd complications were rerupture of Achilles tendon in 8 cases and mild wound infection in 3 cases, but the patients who were repaired by the three-tissne bundle technique showed no complications except mild wound infection in one case.