Evaluation of a modified Bunnell suture technique with sequential tensioning for tension-offloading in Achilles tendon rupture repair: a case series and description of the surgical technique.

Abdulla Aljawder, Noor Jaragh, Osama Zeidan, Maryam Almahmeed

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Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Abdulla AljawderOrthopaedic Surgery Department, King Hamad University Hospital, Building 2435, Road 2835, Block 228, PO Box 24343, Busaiteen, Bahrain.

Noor JaraghSchool of Medicine, Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB), Building 2441, Road 2835, Block 228, Busaiteen, PO Box 15503, Adliya, Bahrain.

Osama ZeidanSchool of Medicine, Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB), Building 2441, Road 2835, Block 228, Busaiteen, PO Box 15503, Adliya, Bahrain.

Maryam AlmahmeedOrthopaedic Surgery Department, King Hamad University Hospital, Building 2435, Road 2835, Block 228, PO Box 24343, Busaiteen, Bahrain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute Achilles tendon (ATR) rupture is a common and potentially disabling injury, particularly in active young adults. Whilst operative repair offers lower re-rupture rates, traditional open techniques carry risks of wound complications and delayed mobilization. We describe a modified limited-open repair technique incorporating sequential suture tensioning to enhance functional recovery and enable early weight-bearing. Our case series presents five patients (aged 33-46) with acute ATR managed using a lateralised limited-open approach, preserving the paratenon. A modified Bunnell suture technique with FiberTape was applied using three crisscrossed loops, each tensioned sequentially from distal to proximal. Postoperative care included early mobilization and physiotherapy. ATRS scores ranged from 75 to 99 (mean: 88.8). The technique demonstrated biomechanical stability, early recovery, and good outcomes.

Indexed as

Achilles tendon ruptureearly rehabilitationlimited-open surgerymodified Bunnell suturesequential tensioning

Identifiers

PMID41768321

DOI10.1093/jscr/rjag111

PMCPMC12947790

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