What is the more common complication of percutaneous Achilles repair compared with open repair?

• A. Sural nerve injury
• B. Wound infection
• C. Deep vein thrombosis
• D. Tendon elongation

Answer: (A)

Percutaneous Achilles repair carries a higher risk of injury to the sural nerve because the suturing passes are done with small, blind incisions and instruments near the posterolateral Achilles region where the sural nerve runs. The nerve travels close to the Achilles tendon in this area, so percutaneous techniques can inadvertently transect or stretch it, causing sensory changes along the lateral foot. In contrast, open repair uses direct visualization and dissection, allowing protection of the nerve, which reduces this complication. Wound infection is more commonly associated with open repair due to the larger skin incision and tissue disruption, while deep vein thrombosis risk and tendon elongation are not as specifically tied to the surgical approach.