Limited-Incision Kager's Fascia Flap Coverage Versus Open Repair for Acute Achilles Tendon Rupture: A Retrospective Comparative Study.

@article{liu2026limitedincision,
  title = {{Limited-Incision Kager's Fascia Flap Coverage Versus Open Repair for Acute Achilles Tendon Rupture: A Retrospective Comparative Study.}},
  author = {Changhuan Liu and Zheng Wang and Xue Fang and Wang Zhang and Lekai Zhu and Haodong Jiang and Wei Tan and Min Zhou and Zonghuan Li and Xiaqing Yang and Pengcheng Li and Xi Chen and Shuilian Luo and Zhe Xie and Xin Wang},
  journal = {Orthopaedic surgery},
  year = {2026},
  month = oct,
  doi = {10.1111/os.70456},
  url = {https://europepmc.org/article/MED/42951869},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Limited-Incision Kager's Fascia Flap Coverage Versus Open Repair for Acute Achilles Tendon Rupture: A Retrospective Comparative Study.
AU  - Changhuan Liu
AU  - Zheng Wang
AU  - Xue Fang
AU  - Wang Zhang
AU  - Lekai Zhu
AU  - Haodong Jiang
AU  - Wei Tan
AU  - Min Zhou
AU  - Zonghuan Li
AU  - Xiaqing Yang
AU  - Pengcheng Li
AU  - Xi Chen
AU  - Shuilian Luo
AU  - Zhe Xie
AU  - Xin Wang
PY  - 2026
DA  - 2026/10/28
JO  - Orthopaedic surgery
DO  - 10.1111/os.70456
UR  - https://europepmc.org/article/MED/42951869
AB  - Purpose  There is ongoing debate within the medical community regarding the optimal surgical technique for repairing Achilles tendon ruptures. Therefore, this study aimed to compare a novel limited-incision Kager's fascia flap coverage technique with conventional open repair for acute Achilles tendon rupture.Methods  Ninety patients surgically treated for acute closed Achilles tendon rupture between January 2017 and December 2021 were retrospectively followed, including 41 with limited-incision Kager's fascia flap coverage technique and 49 with traditional open surgical suture. Functional outcomes were evaluated at 12 months postoperatively using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the Achilles Tendon Total Rupture Score (ATRS). Color Doppler ultrasound examination of Achilles tendon blood supply was performed at 3 months postoperatively to assess hemodynamic parameters. To evaluate the influence of age on outcomes, patients were divided into ≥ 50 years and < 50 years subgroups.Results  The limited-incision Kager's fascia flap coverage group demonstrated superior outcomes compared with the traditional open surgery group. At 12-month follow-up, the fascia flap group had significantly higher AOFAS scores (91.43 ± 2.74 vs. 84.80 ± 2.85) and ATRS scores (94.56 ± 2.45 vs. 86.26 ± 3.15) than the control group (both p < 0.001). At 3-month postoperative ultrasound assessment, the fascia flap group also showed better hemodynamic parameters, with higher peak systolic velocity (11.44 ± 2.06 cm/s vs. 10.39 ± 1.83 cm/s, p = 0.012), higher end-diastolic velocity (4.45 ± 0.64 cm/s vs. 3.36 ± 0.51 cm/s, p < 0.001), and lower resistance index (0.60 ± 0.06 vs. 0.67 ± 0.08, p < 0.001) compared with the control group. In age-stratified analyses, the functional and hemodynamic advantages of the fascia flap technique showed consistent trends across both age subgroups, suggesting potential benefits for older patients. All differences were statistically significant (p < 0.05).Conclusion  The limited-incision Kager's fascia flap coverage technique for treating acute closed Achilles tendon ruptures shows certain efficacy, improving limb function, reducing surgery-related injuries, and potentially promoting Achilles tendon healing by enhancing local blood supply at the rupture site, thereby improving clinical outcomes and outperforming traditional open surgery. Simultaneously, the technology demonstrates good efficacy across different age groups.
SN  - 1757-7853
SN  - 1757-7861
ER  -