The risk of injury to the sural nerve during Achilles Tendon Repair using the Achillon Device: A cadaveric study

The conventional open approach to Achilles Tendon Repair (ATR) has been associated with wound breakdown and infection. In an attempt to decrease the risk of iatrogenic wound complications the mini-open/percutaneous method for ATR has been developed. However, `blind' ATR using the percutaneous method risks damage to the sural nerve. Using intact cadaveric specimens, the current investigation attempted to quantify the risk of sural nerve injury using the Achillon Device. Findings demonstrate a 28% violation of the sural nerve by specimen and a 15% sural nerve violation rate per needle pass (n=54 total needle passes). Sural nerve violation was significantly increased during needle passage through outlet #1 vs. outlet #3 of the Achillon device. A substantial risk to sural nerve injury remains when utilizing the Achillon device for Achilles Tendon Repair.