{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:25:08Z","timestamp":1777613108076,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T00:00:00Z","timestamp":1454457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Limited-open and percutaneous Achilles tendon (AT) repair techniques have limited visibility, which may result in sural nerve violation and poor tendon targeting. The goal of this study was to assess the in vivo rotation of the AT and its distance to the sural nerve in ruptured and nonruptured ATs to develop guidelines to aid in limited-open and percutaneous repair techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted to identify magnetic resonance imaging (MRI) studies of patients with ruptured and healthy (nonruptured) ATs. AT rotation and distance to the sural nerve in the anterior-posterior (A-P) and medial-lateral (M-L) planes were measured at the level of and proximal to the ankle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The AT was externally rotated in both ruptured and nonruptured cohorts. Ruptured ATs showed greater external rotation than nonruptured ATs at the ankle (15.8 \u00b1 16.2 degrees vs 5.9 \u00b1 9.0 degrees,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008) but not at 10 cm proximal to the tendon\u2019s insertion (10.9 \u00b1 10.9 degrees vs 6.1 \u00b1 8.4 degrees,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .139). Proximal AT rotation was negatively correlated with rupture height (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.477,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .029). At 4 cm proximal to the AT insertion, the sural nerve was closer anteriorly to and farther laterally from the AT in ruptures than in nonruptures (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). At 10 cm proximal to the AT insertion, the sural nerve was farther posteriorly and laterally from the AT in ruptures than in nonruptures (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .027 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found that the AT was more externally rotated in ruptured than in nonruptured tendons at the ankle and that its distance to the sural nerve differed between the 2 cohorts in the A-P and M-L planes, likely due to increased AT rotation and swelling with ruptures. To minimize sural nerve injury and improve tendon targeting, we suggest an external rotation of 11 degrees at the proximal end of the rupture and 16 degrees at the distal end when using percutaneous and limited-open AT repair devices to try to minimize sural nerve violation and increase tendon capture, which can decrease rates of complication and rerupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100716628915","type":"journal-article","created":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T22:28:35Z","timestamp":1454538515000},"page":"636-643","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["MRI Evaluation of Achilles Tendon Rotation and Sural Nerve Anatomy"],"prefix":"10.1177","volume":"37","author":[{"given":"Aoife","family":"MacMahon","sequence":"first","affiliation":[{"name":"Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan T.","family":"Deland","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huong","family":"Do","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan S.","family":"Soukup","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn M.","family":"Sofka","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantine A.","family":"Demetracopolous","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"DeBlis","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,2,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100712473097."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079201300610"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2012.09.010."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2006.031328."},{"key":"e_1_3_2_6_2","first-page":"107","article-title":"The structure of the calcaneal tendon (of Achilles) in relation to orthopedic surgery, with additional observations on the plantaris muscle","volume":"83","author":"Cummins EJ","year":"1946","unstructured":"Cummins EJ, Anson BJ. The structure of the calcaneal tendon (of Achilles) in relation to orthopedic surgery, with additional observations on the plantaris muscle. Surg Gynecol Obstet. 1946;83:107-116.","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714524550."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.304095188."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1343-6."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659302100516."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.10.016."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(96)80011-1."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500404."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701116"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715589632."},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514540599."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20140225-64."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506293255."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.04.076."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12253."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.02.031."},{"issue":"4","key":"e_1_3_2_22_2","first-page":"295","article-title":"Torsion of the Achilles tendon in man and its anatomical and surgical significance [in Japanese]","volume":"43","author":"Morimoto I","year":"1968","unstructured":"Morimoto I, Ogata T. Torsion of the Achilles tendon in man and its anatomical and surgical significance [in Japanese]. Kaibogaku Zasshi. 1968;43(4):295-302.","journal-title":"Kaibogaku Zasshi"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01249.2013."},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2013.11.005."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100604."},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1943.01220110200033."}],"container-title":["Foot &amp; Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100716628915","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1071100716628915","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100716628915","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:25:03Z","timestamp":1777411503000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1071100716628915"}},"subtitle":["Implications for Percutaneous and Limited-Open Achilles Tendon Repair"],"short-title":[],"issued":{"date-parts":[[2016,2,3]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1177\/1071100716628915"],"URL":"https:\/\/doi.org\/10.1177\/1071100716628915","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,3]]}}}