The Management of Achilles Tendon Ruptures

A tear of the Achilles tendon is not an uncommon injury in sporting activity and is quite dramatic when it occurs, because the calf muscles and the connected Achilles tendon play such an important function. It is more likely to occur in explosive activities like tennis. The real issue is that the achilles tendon and the two muscles connected to it cross two joints (the knee and the ankle) and if both joints are moving in contrary directions at the same time, particularly if instantly (as can happen in tennis), then the probability of something failing is pretty high. The treating of an achilles tendon rupture is a little debatable with there being two options that the majority the published research shows have virtually identical outcomes.

One option is conservative and the other is surgical. The conservative choice is commonly putting the lower limb in cast that holds the foot pointing downwards slightly. Normally it takes up to six weeks to heel up and after the cast is removed, there ought to be a slow and gentle come back to physical activity. Physical therapy is usually used to help with that. The operative choice is to surgically stitch the two edges of the tendon back together again, this is followed by a period in a cast that is shorter than the conservative option, and is followed by a similar steady and slow return to activity. When longer term results are compared the final outcome is generally about the same, but the operative technique has the added potential for surgical or anaesthetic complications that the conservative approach does not have. The decision as to which approach is better will have to be one dependent on the experiences of the doctor and the preferences of the individual with the rupture. There is a trend for competitive athletes to go along the surgical option as it is considered that this will give a improved short term outcome and get them back to the sports field quicker.

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