Published: 2018-02-23

Modified gift box technique for acute compound posttraumatic Achilles tendon repair in young patients

Tushar Singhi, Ashith Rao, Abhay Agarwal, Sunil Shetty, Prakash Samant


Background: Treatment of Achilles tendon rupture in young active patient remains controversial. Open primary repair remains the mainstay of treatment with prolonged rehabilitation and high wound complication rate (20%). In compound injuries it becomes the default treatment. Newer techniques are being tried to decrease re-rupture rate, decrease local complications and facilitate early rehabilitation. Modified gift box technique of open repair, which has shown higher strength of repair in in-vitro studies and good clinical results in the hands of its inventor. The aim of our study was to evaluate the clinical results of this technique in young active patients with compound Achilles tendon injury.

Methods: This is a retrospective study. The parameters recorded at follow up included general demography, ability to single toe raise (on neutral, incline, decline), toe walking for 40 feet, and pain on VAS scale. Achilles tendon total rupture score and modified Rupp score were administered.

Results: Out of the 8 patients included in the study, 7 patients had unilateral tear and 1 patient had bilateral tear. The mean age was 27 yrs (20-35) and mean duration of follow up was 17.4 months (08-24 months). Single toe raise and toe walking for 40 ft. was possible in all patients. Two patients complained of grade 2 pain on VAS Scale. The ATRS score was 97.1 (94-99) and modified Rupp score was 28.3 (26-29).

Conclusions: Modified gift box technique gives excellent results in young active patients with compound Achilles tendon injury with no re-rupture and return of pre-injury activity.


Compound Achilles injury, Modified gift-box

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