The modified mini-open technique for repairing total ruptured Achilles tendon using fiber wire with calcaneal fixation. A prospective case series

BACKGROUND: The purpose of this study was to evaluate clinical outcomes and complications of our modified Maffuli's mini-open technique for repairing acute Achilles tendon rupture using fiber wire and calcaneal fixation. MATERIAL AND METHODS: Between January 2017 and August 2020, 21 patients with acute rupture of the Achilles tendon who underwent the modified mini-open Maffulli's procedure have been enrolled in the study. RESULT: All surgical incisions healed well without scar adhesions or infections. One year postoperatively, the ATRS score and AOFAS score were 91.2 ± 1.8; 97.2 ± 1.6 respectively; the range of ankle joint movement was normal. Patients could return to their work and their light sporting activities at the time of 16.9 ± 1.1 weeks and 19.7 ± 0.9 weeks postoperatively, respectively. 21 out of 21 patients were able to perform single heel raise. There were no sural nerve injuries, re-ruptures, tendon elongation, or deep vein thromboses. CONCLUSION: We have shown that the modified Maffulli's technique using fiber wire with a calcaneal fixation for repairing acute Achilles tendon ruptures to be a safe and reliable method without requiring specialized or expensive materials. It allows a durable repairing, a limitation of healing problems, and a quick return to physical therapy and full activity. This technique can be widely employed in a low-income country.