# The Usefulness of Concomitant Ultrasound Guidance With Surgery for Acute Achilles Tendon Rupture Using an Internal Brace

## TL;DR

This study shows that using ultrasound during surgery for Achilles tendon rupture can shorten operation time and improve healing outcomes.

## Contribution

The study introduces the use of intraoperative ultrasound with an internal brace for precise suturing in acute Achilles tendon rupture repair.

## Key findings

- Group A had significantly shorter operative times compared to Group B.
- Group A showed lower high-intensity areas on T2-weighted MRI, indicating better healing.
- No re-ruptures or wound infections occurred in either group.

## Abstract

Background

This study investigated the usefulness of intraoperative ultrasonography in the treatment of acute Achilles tendon rupture (ATR) using an internal brace (Achilles Midsubstance SpeedBridge, Arthrex Inc., Naples, FL), a technique that provides strong internal fixation.

Methodology

Forty-three patients were included and divided into two groups: Group A (n = 22), which received ultrasonography, and Group B (n = 21), which did not. In Group A, ultrasonography was used during suturing with a specialized jig to confirm the suture needle's position at the center of the proximal stump. Postoperative care in both groups involved initiating active dorsiflexion exercises on the day following surgery and permitting weight-bearing without orthosis once 0° dorsiflexion was achieved. The operative time, Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, T2-weighted magnetic resonance imaging (MRI) findings at three months postoperatively, and complications were evaluated.

Results

Group A had a significantly shorter operative time (41.9 ± 7.5 minutes vs. 52.1 ± 6.5 minutes, P < 0.001) and a lower percentage of high-intensity areas on T2-weighted MRI (1.76% ± 2.68% vs. 8.74% ± 7.02%, P < 0.001) compared to Group B. No significant difference was observed in JSSF scale scores (P = 0.948). Additionally, no cases of re-rupture or wound infection were reported in either group.

Conclusions

Intraoperative ultrasonography in conjunction with this method may enable precise and reliable suturing, facilitating strong internal fixation and potentially enhancing clinical outcomes.