Ruptured Achilles Tendon

posted on 19 Mar 2015 22:22 by redundantmasque30
Overview
Achilles Tendon The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump. Although the Achilles tendon can withstand great stresses from running and jumping, it is vulnerable to injury. A rupture of the tendon is a tearing and separation of the tendon fibers so that the tendon can no longer perform its normal function.

Causes
The cause of Achilles tendon ruptures besides obviously direct trauma, is multifactorial. In many instances the rupture occurs about 2-6 cm before its attachment to the calcaneous (heel bone). In this area there is a weaker blood supply making it more susceptible to injury and rupture. Rigid soled shoes can also be the causative factor in combination with the structure of your foot being susceptible to injury.

Symptoms
A classic sign of an Achilles tendon rupture is the feeling of being hit in the Achilles are. There is often a "pop" sound. There may be little pain, but the person can not lift up onto his toes while weight bearing.

Diagnosis
A diagnosis can be made clinically, but an MRI or ultrasound scan can confirm it. On examination, the patient will present with reduced plantarflexion strength, a positive Thompson test and potentially, a palpable gap in the Achilles. The whole length of the tendon should be examined to check for injuries that can occur at the insertion and the musculotendinous junction.

Non Surgical Treatment
Two treatment options are casting or surgery. If an Achilles tendon rupture is untreated then it may not heal properly and could lead to loss of strength. Decisions about treatment options should be made on an individual basis. Non-surgical management traditionally is selected for minor ruptures, less active patients, and those with medical conditions that prevent them from undergoing surgery. The goal of casting is to allow the tendon to slowly heal over time. The foot and ankle are positioned to bring the torn ends of the tendon close together. Casting or bracing for up to 12 weeks or more may be necessary. This method can be effective and avoids some risks, such as infection, associated with surgery. However, the likelihood of re-rupture may be higher with a non-surgical approach and recovery can take longer. Achilles Tendonitis

Surgical Treatment
The best treatment for a ruptured Achilles tendon in an active individual is typically surgery. While an Achilles rupture can sometimes be treated with a cast, splint, brace, or other device that will keep your lower leg from moving, surgery provides less chance that the tendon will rupture again and offers more strength and a shorter recovery period. Surgery may be delayed for a period of a week after the rupture, to let the swelling go down. There are two types of surgery to repair a ruptured Achilles tendon and both involve the surgeon sewing the tendon back together through the incision. Open surgery, the surgeon makes a single large incision in the back of the leg. Percutaneous surgery, the surgeon makes a number of small incisions rather than one large incision. Depending on the condition of the torn tissue, the repair may be reinforced with other tendons.