HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Majewski, M. Articles by Ochsner, P. Search for Related Content PubMed PubMed Citation Articles by Majewski, M. Articles by Ochsner, P. Related Collections Achilles tendon Operative

Avoiding Sural Nerve Injuries During Percutaneous Achilles Tendon Repair

From the Department of Orthopaedic Surgery, Kantonsspital Liestal, Liestal, Switzerland

^* Address correspondence to Martin Majewski, MD, Department of Orthopaedic Surgery, Kantonsspital Liestal, Rheinstrasse 26, CH-4410 Liestal, Switzerland (e-mail: majewski01{at}yahoo.de).

Background: Sural nerve injury is a reported risk during percutaneous repair of the Achilles tendon.

Hypothesis: Exposure of the sural nerve during percutaneous repair can minimize the risk of nerve injury.

Study Design: Case control study; Level of evidence, 3.

Methods: The authors retrospectively examined the results of 84 patients who were treated for acute Achilles tendon rupture at 2 different hospitals. Both hospitals used the same percutaneous repair technique, except that the sural nerve was exposed in the 38 patients (mean age, 38 years; range, 23–68 years) of one hospital; the nerve was not exposed in the 46 patients (mean age, 42 years; range, 24–71 years) of the other hospital (the nonexposure group).

Results: All patients recovered and returned to work after 44 days (range, 5–202 days). All patients returned to their previous sports levels within 1 year. On the 100-point Hannover Achilles Tendon Score, the mean score was 81 points (range, 44–100 points). The overall incidence of sural nerve related complications was 18%. All sural nerve lesions occurred in the nonexposure group. In the total study population, there were 3 cases of deep vein thrombosis, 1 rerupture, and 1 case of infection.

Conclusion: Sural nerve injuries can be minimized during surgery by carefully placing the stab incisions to expose the nerve so as to avoid it during repair. If the sural nerve is exposed, percutaneous repair of the ruptured Achilles tendon is a safe and reliable method of treating Achilles tendon ruptures.

Key Words: Achilles tendon rupture • percutaneous suture repair • sural nerve injury

This article has been cited by other articles:

				R. Metz, E.-J. M. M. Verleisdonk, G. J.-M.-G. van der Heijden, G.-J. Clevers, E. R. Hammacher, M. H. J. Verhofstad, and C. van der Werken Acute Achilles Tendon Rupture: Minimally Invasive Surgery Versus Nonoperative Treatment With Immediate Full Weightbearing--A Randomized Controlled Trial Am. J. Sports Med., September 1, 2008; 36(9): 1688 - 1694. [Abstract] [Full Text] [PDF]

				M. Citak, K. Knobloch, K. Albrecht, C. Krettek, T. Hufner, J. Karlsson, and H. Alfredson Anatomy of the sural nerve in a computer-assisted model: implications for surgical minimal-invasive Achilles tendon repair * COMMENTARY 1 * COMMENTARY 2 Br. J. Sports Med., July 1, 2007; 41(7): 456 - 458. [Abstract] [Full Text] [PDF]