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Acute Achilles Tendon Rupture Muhammad Farrukh Bashir FCPS(ortho)

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Presentation on theme: "Acute Achilles Tendon Rupture Muhammad Farrukh Bashir FCPS(ortho)"— Presentation transcript:

1 Acute Achilles Tendon Rupture Muhammad Farrukh Bashir FCPS(ortho)

2 Background Largest, most powerful tendon in body Formed by gastrocnemius and soleus

3 Presentation Adults 40-50 y.o. primarily affected (M>F) Athletic activities, usually with sudden starting or stopping “Snap” in heel with pain, which may subside quickly

4 Factors to consider 25% of patients have previous symptoms of Achilles inflammation Associated conditions: –Steroid use –Quinolones –Inflammatory arthritis

5 Diagnosis Weakness in plantarflexion Gap in tendon Positive Thompson test

6 Imaging X-rays –Indicated if fracture or avulsion fracture suspected Ultrasound or MRI –Reveal tendon degeneration, if present

7 Treatment Non-operative versus operative treatment controversial –Several methods described for each

8 Non-operative Cast immobilization –Traditional recommendation is 8 weeks of immobilization –Wallace recommended patellar tendon bearing orthosis for weeks 4-8 –Functional brace with semi- rigid tape and polypropylene orthoses for duration of treatment also described Rerupture rate 8-39% reported

9 Operative Open repair –Locking stitch, +/- augmentation with plantaris or mesh –Post-op care = Casting for 6-8 weeks –Risks: Infection (4- 21%), Rerupture (1- 5%)

10 Operative Percutaneous –Bunnell stitch –Weaker than open repair (Rerupture 0- 17%) –Risk of sural nerve injury (0-13%) –Decreased infection risk

11 Risk Factors for Wound Complication –Age –Tobacco –Diabetes –Female gender –Steroid use –Treatment delay –Low energy injury


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