[Primary surgical repair with the Krackow technique combined with plantaris tendon augmentation in the treatment of acute Achilles tendon ruptures].

OBJECTIVES

We evaluated the long-term results of acute Achilles tendon ruptures treated with primary end-to-end repair with the Krackow technique combined with augmentation using the plantaris tendon.

METHODS

Thirty-six patients (31 males, 5 females; mean age 34 years; range 21 to 42 years) underwent primary surgical repair for acute Achilles tendon ruptures. Most of the patients (31/36) were involved in regular sportive activities. Surgery included end-to-end repair with the Krackow technique (locking-loop) combined with plantaris tendon augmentation. All the patients received a standardized progressive postoperative rehabilitation program. The results were evaluated with respect to time to return to work and preinjury activity levels and by a scoring system covering objective and subjective parameters. The mean follow-up was 54 months (range 28 to 78 months).

RESULTS

At surgery, 34 patients (94.4%) and two patients (5.6%) were found to have complete and partial ruptures, respectively. The mean operation time was 50 minutes (range 40 to 70 minutes). The patients returned to work after a mean of eight weeks (range 6 to 9 weeks) and to preinjury sportive activities after a mean of 17 weeks (range 14 to 20 weeks). The overall mean scoring was good (88 out of 100) at the end of a year follow-up. Early or late complications included superficial wound infections in five patients and partial rupture recurrence in one patient.

CONCLUSION

Our results showed that the Krackow technique combined with plantaris tendon augmentation and a rehabilitation protocol aiming early motion enabled physiological tendon healing.