Achilles Tendon Repair Under Local Anesthesia

Despite many different studies and metaanalyses, there is no universal agreement about the optimal management strategy of acute total Achilles tendon rupture. Most authors prefer open surgical repair as it contributes to a low incidence of re-rupture, ranging from 1,4% to 2,8% (Cetti et al., 1993; Inglis & Sculco, 1981; Lo et al., 1997; Maffulli, 1999; Thermann & Zwipp, 1989; Wills et al. 1986). Strong repair with the restored length and optional augmentation offers the possibility of early functional treatment (Carter et al., 1992). As it is associated with significant number of complications (11,8% to 21,6%) as well as high costs, some authors advocate conservative treatment (Cetti et al., 1993; Kocher et al., 2002; Lea & Smith, 1972; McComis et al., 1997; Nistor, 1981; Wills et al. 1986). High incidence of reruptures (12% to 17%), lengthened tendon and loss of strength are the main arguments for the opponents to criticize this method (Cetti et al., 1993; Inglis et al., 1976; Inglis & Sculco, 1981; Kocher et al., 2002; Lo et al., 1997; Maffulli, 1999; Wills et al. 1986, Washburn et al., 1992, Webb & Bannister, 1999). There are more and more papers favouring functional conservative treatment, what can yield to better results according to the lower re-rupture rate and better functional results (Kangas et al., 2003; McComis et al., 1997; Thermann et al., 1995; Twaddle & Poon, 2007; Willits et al., 2010).