الفهرس 
Anatomy and histologyOnly 14 pages are availabe for public view
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Abstract
Background; The Achilles tendon is the strongest and biggest tendon in the human body. It is most frequently ruptured in the 3rd and 4th decade of age. Most studies had reported that it usually ruptures during sports practice. There are variants of the mechanism of injury but most commonly is pushing off the forefoot in the weight bearing position while the knee is extended. Also, sudden dorsiflexion of the ankle in plantarflexion position of the ankle such as slips of the foot into a hole.
Aim: to compare open versus percutaneous repair for treating Acute Achilles tendon rupture in a systematic review and evaluate the functional outcomes of each method to assist the orthopedic surgeons in selecting their decision and provide intervention recommendations by the best available evidence.
Methods: This systematic review study included randomized control trails (RCTs) and controlled clinical trials. With exclusion of Case reports, Case series studies and Cross-sectional studies. The number of patients included in this study divided into 165 patients (50.2%) treated with open repair and 164 patients (49.8%) treated with percutaneous repair.
Results: Infection rate in the open group was higher and subgroup analysis of four articles showed no significant difference p value 0.174 for superficial infection and p value 0.155 for deep infection. No significant difference was seen regarding the rate of re-rupture P-value 0.708. OR had more patients with rerupture as 4 of 165 patients (2.4%) while 3 of 164 patients (1.8%) in PR. High statistical significance for operation time between the 2 groups with P-value 0.001 indicating PR with mean 35.47 ± 11.30 minutes is faster procedure than OR with mean 61.59 ± 13.8 minutes. Regarding ATRS there is no statistical significance for both groups with P value 0.776. There is statistical significance for both groups regarding AOFAS with P-value 0.001. The open group had 97.2 points regarding AOFAS more than 95.97 points for the percutaneous group. There is high statistical significance regarding scar length for both groups with P-value less than 0.001 also it shows is high statistical significance regarding scar problems with p value 0.005 but no statistical significance regarding wound problems with p value 0.832 also no statistical significance for sural nerve injury with p value 0.310 and finally no statistical significance for DVT as p value 0.544.
Conclusion: Percutaneous surgical repair for AATR has the advantages of reduced operation time, less infection rate and higher AOFAS score. Despite the higher incidence of sural nerve injury, the study showed that percutaneous repair has been superior to open repair for treating AATR.