Achilles Tendon Ruptures: Nonoperative Treatment, Open Repair or Percutaneous Repair?

There is great controversy regarding the treatment of acute Achilles tendon rupture. Historically it was believed that nonoperative treatment was associated with a high rate of rerupture and it was generally considered that conservative treatment should only be performed on patients in whom surgery was contraindicated. However, recent studies show good results, even similar to surgical treatment, provided that early loading and rehabilitation of the Achilles tendon are performed. However, there is no consensus as to the following parameters: the time of immobilization, discharge, or type of exercises to be performed. Percutaneous or minimally invasive surgical treatment has shown similar results to open surgical treatment, but with a lower rate of skin complications; however, minimally invasive techniques may be associated with injury to the sural nerve. Good functional results and patient satisfaction continue to be achieved with classic open surgical treatment.