Surgical repair of the Achilles tendon: the lateral approach

Introduction: Surgical repair of the Achilles tendon is associated with complications that are often wound related. Incisions in the midline or medial to the tendon pass through poorly vascularized tissue. A laterally placed incision passes through tissue with a rich vascular supply. Methods: A case-note analysis and telephone questionnaire was conducted for a consecutive series of 71 patients who had repair of their Achilles tendon via a lateral approach. Results: There was one case of superficial wound infection, one case of a sural nerve lesion, and two cases of reflex sympathetic dystrophy. There were no cases of deep wound infection, wound necrosis or tendon re-rupture. All patients were satisfied with scar cosmesis. Conclusion: The low rate of complications compared with that reported in other studies leads us to recommend the lateral approach for surgical repair of the Achilles tendon.