BACKGROUND: Percutaneous and minimally invasive suturing techniques are very important in the treatment of acute Achilles tendon ruptures because they combine the advantages of surgical treatment (low re-rupture rate) and non-opervative treatment (low risk of complications). In the authors' approach, the percutaneous, peritendineum-preserving technique with the Dresden instrument has proven itself as a standard treatment for 20 years.

DRESDEN TECHNIQUE: Strict adherence to the original Dresden technique with posteromedial incision and subfascial preparation is crucial for the safe avoidance of the sural lesions regularly reported in percutaneous procedures. The rupture zone and the peritendineum should not be opened. By adding a third suture and using non-absorbable suture material, stability comparable to the open Krackow suture technique is achieved. Functional aftertreatment with protection in a special boot and appropriate supervision of the patient aims at early rehabilitation while minimizing the risk of re-rupture or loss of tension.

OUTLOOK: The focus of future efforts should be to further improve treatment results through individualized postoperative treatment adapted to tendon healing.