Achilles Rupture Repair with Mini-Open Approach

The optimal approach for treating acute Achilles tendon ruptures continues to be a subject of debate in the current foot and ankle literature. The traditional open approach for fixing an Achilles tendon ruptures typically involves a large 5 to 8 cm incision along back of the ankle over the rupture site. This has been a commonly utilized incision so that the surgeon can fully visualize the rupture site and stitch the tendon ends together.

I utilize the mini-open approach for the treatment of acute Achilles tendon. I believe the mini-open approach for treating Achilles ruptures offers patients the best possible outcome. Utilizing a 1-2 cm incision (pictured) along the back of the ankle, I am able to surgically repair the tendon while still visualizing the majority of the rupture site. This minimally invasive approach decreases surgical site infection rates through a shorter operating room time, lessens the amount of dissection through a smaller incision, and minimizes post-operative pain due to less trauma to the surrounding soft tissues, while also offering the same benefits of surgery as a traditional open approach, such as improved functional outcomes and lower rates of re-rupture. Although there is certainly a learning curve to the mini-open approach, the improved outcomes suggest it is a much better alternative moving forward for repairing the majority of acute Achilles tendon ruptures. The current literature continues to support the case of the mini-open approach being a better option for treating acute Achilles tendon ruptures in comparison to both conservative management as well as the traditional open method.