Achilles Tendon Rupture

Wikis > Orthopaedics > Trauma > Achilles Tendon Rupture

http://www.physio-pedia.com/index.php?title=Achilles_tendon_repair

http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=13205

http://www.aspetar.com/journal/viewarticle.aspx?id=34#.U9nKSWPzlwU

http://www.expertconsultbook.com/expertconsult/ob/book.do?method=display&type=bookPage&decorator=none&eid=4-u1.0-B978-1-4377-3792-9..00116-8&isbn=978-1-4377-3792-9

http://cjem-online.ca/v11/n3/p242

http://www.podiatrytoday.com/current-concepts-in-treating-achilles-tendon-ruptures

Usually occurs at area of least blood supply – 2 to 6 cm proximal to calcaneal insertion.

Aetiology:
Direct (eg laceration)
Indirect (eg forced dorsiflexion and knee extension)

Clinical features:
Patients usually recalls precipitating event
Pain and swelling at posterior ankle; weakness
May be able to palpate deficit in tendon
Some plantarflexion is possible – from other muscles
Thompson’s test – squeeze calf – if foot doesn’t plantarflex  rupture
On x-ray – Kager’s triangle should normally be clear – if rupture  increased soft tissue density in triangle

Treatment:
Conservative:
Generally used in older and more sedentary patients
Non-weightbearing below knee equinus cast – change every two weeks gradually bringing foot to neutral.

Surgical:
Generally used in younger and more active patients
Suture ends of tendon together  equinus cast – replace cast to bring foot gradually back to neutral

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