End-to-End Operative Repair of Achilles Tendon Rupture

We present the long-term results of operative repair in 23 consecutive patients with Achilles tendon ruptures, treated between 1984 and 1991, to evaluate our treat ment method and determine the clinical causes of rupture. Fifty-four percent of ruptures occurred in peo ple in their 30s; 90% occurred during participation in acceleration-deceleration sports. All but three patients were treated within 1 week of injury with open, opera tive, end-to-end repair of the Achilles tendon. The re maining three patients were treated more than 3 weeks after injury. All patients followed a standard postoper ative regimen. Followup averaged 3.6 years (range, 1 to 7.5). Seventeen patients were available for Cybex analysis, and the remaining patients were interviewed personally or by telephone. Subjectively, patients were very satisfied with the results of treatment. Objectively. physical examination and Cybex testing to measure strength and endurance revealed results somewhat better than those previously reported with operative repair. No patient experienced a rerupture, although one attenuated repair was noted 9 months postopera tively. Only two minor wound problems were recorded. Long-term results revealed near-normal function when comparing the injured side with the uninjured side. Ninety-two percent of patients returned fully to their preinjury levels of activity.