Complete Ruptures of the Achilles Tendon Medscape

Description: Although Achilles tendon ruptures may occur in young athletes, they generally occur in 30- to 40-year-old sedentary males who overexert themselves, usually on weekends. The patient typically presents with pain, ecchymosis, and a history of an audible "pop" in the calf. Usually in these cases, a gap is palpable 2 cm to 6 cm above the insertion of the Achilles tendon; the patient is unable to perform repetitive heel rises; and Thompson, Copeland, and O'Brien tests scores are positive. Usually the diagnosis is made on clinical grounds, but MRI and ultrasound can be useful when the diagnosis is uncertain. During the late 1980s and 1990s, surgical treatment was favored in young active patients and in those with chronic tears. Although simple end-to-end repair achieves good results in acute tears, chronic tears usually require some type of augmentation. The trend in postoperative rehabilitation is moving toward progressive functional protocols.
Medscape Orthopaedics & Sports Medicine eJournal 5(3), 2001 Atkinson & Easley