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Which technique is the better surgical option? In the present study, we compared the two surgical procedures\u2014 modified Mini-open repair versus percutaneous repair\u2014in the treatment of acute Achilles tendon rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2016 to November 2018, 68 matched patients with acute Achilles tendon rupture were divided into treatment group (Mini-open with modified Ma-Griffith technique) and control group (the Ma\u2013Griffith technique). The patients were then treated with different surgical techniques and followed up for no less than 24 months, and the functional outcome scores and complications were retrospectively evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean follow-up time in Mini-open repair group was 29.0\u00b12.9 months, and that in control group was 27.9\u00b12.9 months (<jats:italic>P<\/jats:italic>=0.147). The Mini-open repair group showed reliably higher American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and Achilles tendon Total Rupture Score (ATRS) than the control group in functional assessment (95.0\u00b13.8 vs. 92.3\u00b15.3,<jats:italic>P<\/jats:italic>=0.000; 93.8\u00b13.8 vs. 90.9\u00b14.5,<jats:italic>P<\/jats:italic>=0.000). There was no cases of sural nerve injury in Mini-open repair group, whereas the percutaneous repair group had 5 cases of the same (<jats:italic>P<\/jats:italic>=0.027). No significant differences were found in the calf circumference (32.3\u00b13.9 vs. 31.8\u00b13.6) (<jats:italic>P<\/jats:italic>=0.564), range of motion of the ankle (51.3\u00b14.8 vs. 50.5\u00b14.2,<jats:italic>P<\/jats:italic>=0.362), or wound complications (34\/0 vs. 34\/0) (<jats:italic>P<\/jats:italic>=1.000) between the two groups at the end of the follow-up time. However, the percutaneous repair group had a shorter average operating time (23.1\u00b15.2 min) than that of the Mini-open repair group (27.7\u00b14.3 min) (<jats:italic>P<\/jats:italic>=0.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Acute Achilles tendon ruptures may be treated successfully with a new Mini-open repair system or percutaneous repair technique. However, the Mini-open repair system may represent a superior surgical option, since it offers advantages in terms of direct visual control of the repair, AOFAS Ankle-Hindfoot Score, Achilles tendon Total Rupture Score and risk of sural nerve palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Case-control studies, Level of evidence, 3.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12891-021-04802-8","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T09:02:44Z","timestamp":1635584564000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comparison of mini-open repair system and percutaneous repair for acute Achilles tendon rupture"],"prefix":"10.1186","volume":"22","author":[{"given":"Yong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongkui","family":"Xin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dike","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,30]]},"reference":[{"issue":"3","key":"4802_CR1","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1177\/036354658901700305","volume":"17","author":"L Jozsa","year":"1989","unstructured":"Jozsa L, Kvist M, Balint BJ, Reffy A, Jarvinen M, Lehto M, et al. 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