Traditional Open Achilles Tendon Repair: Supine Positioning.

Achilles tendon repair is traditionally performed in the prone position using a direct posterior approach. Wound complications and nerve injury are possible complications that can occur. Prone positioning is associated with various complications and may prolong operative time. A posteromedial incision in the supine position may mitigate wound and neurologic complications as well as complications inherent to prone positioning. An added benefit is reducing the time required to position prone. This article shares the senior author's preferred technique of supine Achilles tendon repair, outlines indications and contraindications, and offers an in-depth discussion in comparison with traditional prone repair.