Management of acute Achilles tendon rupture. Issue 6 (December 2018)

• Record Type: Journal Article
• Authors: Teoh, Kar Hao; Tanaka, Hiro; Hariharan, Kartik
• Is Part Of: Orthopaedics and trauma. Volume 32:Issue 6(2018:Dec.)
• Page Start: 401
• Page End: 407
• Publication Date: 2018-12
• Subjects: acute Achilles tendon ruptures -- functional rehabilitation -- non-operative -- surgery; Orthopedics -- Periodicals; Traumatology -- Periodicals; 616.7
• DOI: 10.1016/j.mporth.2018.09.002
• Languages: English
• ISSNs: 1877-1327

Abstract

Abstract: With the introduction of functional rehabilitation and early weight bearing, the management of acute midsubstance Achilles tendon ruptures has seen a paradigm shift in conservative methods. The re-rupture rates for non-surgical treatment are similar to those for surgical treatment with the advantage of a decrease in complications. The treatment should be tailored to each individual patient with a shared decision-making process between the surgeon and patient, taking into consideration their occupation, lifestyle, sporting aspirations and expectations. Generally, most patients can be treated non-operatively in centres offering functional rehabilitation. However, surgical repair should be preferred at centres that do not employ functional rehabilitation as it decreases the re-rupture risk in such patients. High-demand, active individuals and athletes should be considered for surgery as non-operative treatment can lead to statistically significant deficits in high-speed plantar flexion strength and hopping ability in the absence of robust sports-oriented functional rehabilitation. If surgical treatment is considered, minimally invasive techniques should be employed to alleviate the risk of wound complications.