Comparison Of Two Operative Methods For The Treatment Of Acute Achilles Tendon Rupture

Objective: To compare the efficacy of the modified Ma-Griffith method combined with minimally invasive smal incision(M-G/MISI)and the modified suture technique(MST)in the treatment of acute rupture of Achilles tendon.Methods: The clinical data of all patients with acute Achilles tendon rupture treated in our hospital from January 2012 to January 2020 were analyzed retrospectively.According to the inclusion and exclusion criteria,a total of 67 patients met the criteria and were divided into two groups according to different surgical methods: M-G/MISI treatment group(34 cases)(all male),MST group 33 cases(female 2 cases,male 31cases).The patient’s hospitalization records were collected,and the gender,age,injured side,time from injury to operation,operation time,hospital stay,intraoperative blood loss,incision length,the American Orthopedic Foot and Ankle Society(AOFAS)and Achilles tendon rupture score(ATRS)at the beginning,third and sixth month after operation,as well as the occurrence of postoperative complications were calculated.Finally,the data were statistically analyzed and compared.Results: The sex of the patients in both groups(M-G/MISI group: all males,MST group: 2 females,31 males),age(M-G/MISI group: 33.94 ±7.19 years old,MST group:36.5 ±9.00 years old),injured side(M-G/MISI group: left/right = 22/ 12;MST group:left/right = 17/16)and the time from injury to operation(M-G/MISI group: 4.85 ±1.60 days,MST group:4.58±1.84 days).There was no significant difference in MST group,but the incision length in M-G/MISI group was shorter than that in MST group(3.79±1.81 cm vs 5.79 ±1.00 cm).The intraoperative blood loss was less in M-G/MISI group(16.47 ±13.23 ml vs 34.55 ±13.01 ml),and the difference was statistically significant.There was no significant difference in the scores of AOFAS and ATRS between the two groups at the beginning and the third month(AOFAS0: 46.91±5.22 vs 47.42±5.02 vs91.21±1.95 vs 90.52 ±1.86).Six months after operation,the score of AOFAS and ATRS in M-G/MISI group was higher than that in MST group(AOFAS6: 97.03 ±2.71 vs93.18±2.04;ATRS6: 96.71±3.51 vs 93.18±2.54).After operation,there were 1 case of secondary rupture of Achilles tendon caused by slip in M-G/MISI group,1 case of infection and 1 case of deep venous thrombosis of Lower limb in MST group.Conclusion: During the follow-up 6 months after operation,the scores of AOFAS and ATRS in M-G/MISI group were better than those in MST group.Moreover,the intraoperative blood loss and incision length of M-G/ Misi group were significantly smaller than those of MST group,so the trauma of M-G/MISI group was less than that of MST group,and the recovery of M-G/MISI group was better than that of MST group in the sixth month.