2009 Clarification of the Simmonds–Thompson test for rupture of an Achilles tendon

Description: The Simmonds–Thompson test, described in 1957 and 1962, respectively, remains the principal clinical test for rupture of an Achilles tendon. However, there is some discrepancy in the literature regarding its mechanical significance. A positive test has been reported to indicate a complete rupture of the tendon, and the cited mechanical reason for the positive test (complete rupture) is the loss of integrity of the soleal part of the tendon. This is consistent with Thompson’s initial description, in which he reported that “... by anatomical dissections ... plantar flexion of the foot depends on an intact soleus muscle attachment to an intact tendon of Achilles.” O’Brien, however, reported that a negative test depended on an intact connection of the gastrocnemius aponeurosis to that of the soleus muscle and further described a needle test to assess this.
James Douglas, MD Michael Kelly, MB BS† Piotr Blachut, MD‡ Can J Surg, Vol. 52, No. 2, April 2009 E40 (full text)