Modified overlapping suture technique for the repair of horse-tail-like achilles tendon tears: technical description and clinical results - Report - MDSpire

Modified overlapping suture technique for the repair of horse-tail-like achilles tendon tears: technical description and clinical results

  • By

  • PengKun Yu

  • Yu Wu

  • Qiang Xu

  • XiaoHong Fan

  • June 15, 2026

  • 0 min

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Clinical Report: Revised Overlapping Suture Method for Achilles Tendon Injuries

Overview

This report discusses the clinical efficacy of a modified overlapping suture technique for treating horse-tail-like Achilles tendon tears, based on a retrospective analysis of 57 patients.

Background

Achilles tendon ruptures are common injuries that can lead to significant functional impairment. Horse-tail-like tears present unique challenges due to the retraction of tendon ends and potential complications from surgical repair.

Data Highlights

MeasurePreoperativePostoperativep-value
AOFAS Score64.92 ± 9.0892.56 ± 6.71<0.01
Muscle Strength (Affected Side)3.2 ± 0.74.62 ± 1.7<0.01
Maximum Plantar Flexion Angle-37.1 ± 3.1°0.072
Dorsiflexion Angle-18.3 ± 2.2°0.773

Key Findings

  • The excellent and good rate of the Arner-Lindholm score after surgery was 98.2%.
  • Postoperative AOFAS scores significantly improved compared to preoperative scores (p < 0.01).
  • Muscle strength of the plantar flexor group improved significantly post-surgery (p < 0.01).
  • No symptoms of peroneal nerve injury were reported after surgery.
  • One patient experienced delayed wound healing, and two patients had re-ruptures due to accidental falls.

Clinical Implications

Surgeons should be aware of the potential for complications, including re-ruptures and delayed healing.

Conclusion

The modified overlapping suture technique can be used to treat horse-tail-like Achilles tendon injuries.

Related Resources & Content

  1. Knee Surgery, Sports Traumatology, Arthroscopy, 2023 -- Outcomes and Complications of Open Versus Minimally Invasive Repair of Acute Achilles Tendon Ruptures
  2. Knee Surgery, Sports Traumatology, Arthroscopy, 2022 -- Endoscopic-Assisted Reconstruction of Chronic Achilles Tendon Ruptures and Re-Ruptures with Semitendinosus Autograft
  3. Knee Surgery, Sports Traumatology, Arthroscopy, 2023 -- Utilization of Free Tendon Grafts in the Surgical Treatment of Chronic Achilles Tendon Tears: A Systematic Review
  4. American Orthopaedic Foot & Ankle Society, 2024 -- Position Statement on Acute Achilles Tendon Ruptures
  5. Knee Surgery, Sports Traumatology, Arthroscopy — Comparative Analysis of Strength and Clinical Outcomes Following Early Versus Late Repair of Achilles Tendon Ruptures
  6. Comparative Biomechanical Analysis of Innovative Dynamic Tape Versus Traditional Tape Suture in Repairing Distal Triceps Tendons: Findings from a Human Cadaver Study with an Aggressive Early Rehabilitation Approach
  7. https://www.aofas.org/docs/default-source/research-and-policy/position-statements/positionstatement_acuteachillesruptures_nov2024.pdf
  8. Outcomes and Complications of Open Versus Minimally Invasive Repair of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-analysis of Randomized Controlled Trials - Ahmed Khalil Attia, Karim Mahmoud, Pieter d’Hooghe, Jason Bariteau, Sameh A. Labib, Mark S. Myerson, 2023
  9. Management of acute Achilles tendon rupture with tendon-bundle technique - PMC

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