Percutaneous repair of the ruptured tendo Achillis

P ercutaneous repair of the ruptured tendo Achillis has a low rate of failure and negligible complications with the wound, but the sural nerve may be damaged. We describe a new technique which minimises the risk of injury to this nerve.The repair is carried out using three midline stab incisions over the posterior aspect of the tendon.A No. 1 nylon suture on a 90 mm cutting needle approximates the tendon with two box stitches.The procedure can be carried out under local anaesthesia.We reviewed 27 patients who had a percutaneous repair at a median interval of 35 months after the injury.They returned to work at four weeks and to sport at 16.One developed a minor wound infection and another complex regional pain syndrome type II.There were no injuries to the sural nerve or late reruptures.This technique is simple to undertake and has a low rate of complications.