Usually occurs at area of least blood supply – 2 to 6 cm proximal to calcaneal insertion.
Direct (eg laceration)
Indirect (eg forced dorsiflexion and knee extension)
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
Generally used in older and more sedentary patients
Non-weightbearing below knee equinus cast – change every two weeks gradually bringing foot to neutral.
Generally used in younger and more active patients
Suture ends of tendon together equinus cast – replace cast to bring foot gradually back to neutral