Achilles Tendon Rupture

Wikis > Orthopaedics > Trauma > Achilles Tendon Rupture

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)

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

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
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