Abstract: Objective To investigate the clinical efficacy of minimally invasive incision on acute closed rupture of Achilles tendon guided by epidural needle. Methods A retrospective case series study was conducted to analyze the operative outcome of 29 patients with Achilles tendon rupture.They were randomly divided into observation group（minimally invasive incision group）and control group（conventional incision group）with 16 and 13 respectively.The interval between injury and operation ranged from 0.5h to 5days.All patients were treated with personalized plaster fixation after surgery，and performed functional exercise for 1～2 months.After one year follow-up at least，the operative time、postoperative complications（wound infection，sural nerve injury，Achilles tendon re-rupture）、AOFAS score and ATRS score in two groups were compared. Results Compared with the conventional group[（48.91±12.56）min]，the mean operative time of the minimally invasive group[（41.78±9.56）min] was slightly longer，but there was no significant difference（P>0.05）.During the follow-up，no postoperative sural nerve injury or Achilles tendon re-rupture occurred in both group，and 3 cases of skin infection and necrosis/delayed healing occurred in the conventional group.By the end of the follow-up，the AOFAS scores of the two groups were significantly improved（P<0.05），but there was no difference in the AOFAS and ATRS scores between the two groups（P>0.05）. Conclusion The duration of minimally invasive incision in the treatment of Achilles tendon rupture under the guidance of epidural needle is slightly longer，but compared with the conventional surgery，it can effectively avoid post-operative complications.

Key words: achilles tendon rupture, minimally invasive incision, epidural needle