{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:28:23Z","timestamp":1772213303105,"version":"3.50.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acute Achilles tendon (ATR) rupture is a common and potentially disabling injury, particularly in active young adults. Whilst operative repair offers lower re-rupture rates, traditional open techniques carry risks of wound complications and delayed mobilization. We describe a modified limited-open repair technique incorporating sequential suture tensioning to enhance functional recovery and enable early weight-bearing. Our case series presents five patients (aged 33\u201346) with acute ATR managed using a lateralised limited-open approach, preserving the paratenon. A modified Bunnell suture technique with FiberTape was applied using three crisscrossed loops, each tensioned sequentially from distal to proximal. Postoperative care included early mobilization and physiotherapy. ATRS scores ranged from 75 to 99 (mean: 88.8). The technique demonstrated biomechanical stability, early recovery, and good outcomes.<\/jats:p>","DOI":"10.1093\/jscr\/rjag111","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T12:32:13Z","timestamp":1770640333000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a modified Bunnell suture technique with sequential tensioning for tension-offloading in Achilles tendon rupture repair: a case series and description of the surgical technique"],"prefix":"10.1093","volume":"2026","author":[{"given":"Abdulla","family":"Aljawder","sequence":"first","affiliation":[{"name":"Orthopaedic Surgery Department, King Hamad University Hospital , Building 2435, Road 2835, Block 228, PO Box 24343, Busaiteen ,","place":["Bahrain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noor","family":"Jaragh","sequence":"additional","affiliation":[{"name":"School of Medicine, Royal College of Surgeons in Ireland \u2013 Medical University of Bahrain (RCSI-MUB) , Building 2441, Road 2835, Block 228, Busaiteen, PO Box 15503, Adliya ,","place":["Bahrain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Zeidan","sequence":"additional","affiliation":[{"name":"School of Medicine, Royal College of Surgeons in Ireland \u2013 Medical University of Bahrain (RCSI-MUB) , Building 2441, Road 2835, Block 228, Busaiteen, PO Box 15503, Adliya ,","place":["Bahrain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Almahmeed","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery Department, King Hamad University Hospital , Building 2435, Road 2835, Block 228, PO Box 24343, Busaiteen ,","place":["Bahrain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022711503859200_ref1","doi-asserted-by":"publisher","first-page":"E356","DOI":"10.1503\/cjs.008321","article-title":"Evidence-based treatment of Achilles tendon rupture","volume":"66","author":"Cohen","year":"2023","journal-title":"Can J Surg"},{"key":"2026022711503859200_ref2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/978-3-662-54181-4_21","volume-title":"Bio-orthopaedics: A New Approach","author":"Aicale","year":"2017"},{"key":"2026022711503859200_ref3","volume-title":"Tendon Regeneration: Understanding Tissue Physiology and Development to Engineer Functional Substitutes","author":"Gomes","year":"2015"},{"key":"2026022711503859200_ref4","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.2106\/JBJS.18.00020","article-title":"Strategies for weight reduction prior to total joint 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Orthopedics","author":"Wagner","year":"2016"},{"key":"2026022711503859200_ref8","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1186\/s13018-025-05748-6","article-title":"Functional outcomes following minimally invasive Achilles rupture repair: a retrospective comparative study of PARS and midsubstance speedbridge techniques","volume":"20","author":"Peabody","year":"2025","journal-title":"J Orthopaedic Surg Res"},{"key":"2026022711503859200_ref9","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.1007\/s00167-014-3180-5","article-title":"Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence","volume":"24","author":"Mark-Christensen","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"2026022711503859200_ref10","doi-asserted-by":"publisher","first-page":"1782","DOI":"10.1016\/j.injury.2014.06.022","article-title":"Accelerated rehabilitation following Achilles tendon repair after acute rupture\u2013development of an evidence-based treatment protocol","volume":"45","author":"Brumann","year":"2014","journal-title":"Injury"},{"key":"2026022711503859200_ref11","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1177\/0363546506294856","article-title":"The Achilles tendon total rupture score (ATRS) development and validation","volume":"35","author":"Nilsson-Helander","year":"2007","journal-title":"Am J Sports Med"},{"key":"2026022711503859200_ref12","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1016\/j.injury.2020.05.010","article-title":"Repair of traumatic avulsed Achilles tendon using double cerclage trans-calcaneal stainless steel sutures: prospective study and review of literature","volume":"51","author":"Hosny","year":"2020","journal-title":"Injury"}],"container-title":["Journal of Surgical Case 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