The Webb-Bannister percutaneous technique for acute Achilles' tendon ruptures: a functional and MRI assessment

Abstract

This was a study of 57 patients treated for Achilles' tendon rupture between 1994 and 2002: 35 with an open repair and 22 with the Webb-Bannister percutaneous technique. The aim of the study was to evaluate this percutaneous method as compared to other percutaneous and open techniques, with respect to functional result and complications. In addition, postoperative MRI was performed on 40 patients in order to determine whether there were any correlations between clinical results and MRI findings. No significant differences were found between the 2 surgical methods with respect to clinical and functional results, and no wound dehiscence or infections were found in the Webb-Bannister group. There was an 8.6% incidence of wound complications in the open repair group. Similarly, return to work times were not significantly different between the groups (4 months for open repair and 3.75 months for percutaneous repair). Two patients experienced re-rupture after open repair and there was 1 re-rupture following the Webb-Bannister technique. Early weight bearing and the use of the percutaneous repair did correlate to increased postoperative tendon lengthening, though this did not appear to have any clinical consequence. MRI did not appear to be of any value in the clinical or functional evaluation, but it demonstrated a relationship between increased tendon diameter and tendon elongation (P=.0038). In those patients with thicker tendon repair sites, the dorsiflexion tended to exceed the uninjured leg. The functional results of the Webb-Bannister technique were comparable to the open repair. This technique is an effective treatment for acute ruptures less wound complications.