Using a Posterior Compartment Fasciotomy and Paratenon Closure in Acute Achilles Tendon Repair.

Soft tissue management, dissection, and handling are of paramount importance during Achilles tendon repair. Although surgical repairs of Achilles tendons have predictably excellent outcomes, complications including wound infection and stiffness are not uncommon. The authors' surgical technique for Achilles tendon repair includes tagging the posterior paratenon for later layered repair and incising the posterior fascia, exposing the flexor hallucis longus muscle belly. This posterior compartment fasciotomy allows for both hematoma evacuation away from the tenuous posterior skin and mobilization of the posterior paratendon for complete closure over the repaired Achilles tendon. With this modified technique, the authors report a 1% infection rate and a 1% failure rate. [Orthopedics. 2016; 39(4):e790-e793.].