Important News About Treatment For Achilles Tendon RupturesIn this study, researchers found that early motion may be the key factor in the successful treatment of Achilles tendon ruptures. Debate has been ongoing for years as to whether Achilles tendon ruptures should be treated surgically or not.
Two groups of patients with acute Achilles tendon ruptures were compared. All patients had been injured within the last 10 days. Group one was treated with a cast for 10 days but no surgery. Group two had surgery to repair the damaged tendon. They were put in a special cast called a hanging equinus cast.
The equinus cast placed the foot in a toe-down position. It prevented the patients from dorsiflexion (moving the foot toward the face). The equinus cast allowed the foot to dorsiflex to neutral and hang down (toes pointed) as far as possible.
Everyone in both groups followed the same rehab program. Exercises, weight bearing, stretches, and exercises were started at the end of the first 10 days.
Results were measured using ankle joint range of motion, calf circumference, and function. The number of re-ruptures and/or complications was also recorded. There was no difference between the two groups when motion was measured.
Reruptures, infections, and wound complications were rare. These problems were much lower in both groups than reported in other studies. The authors suggest that controlled, early motion after Achilles tendon rupture is the missing key to success in treatment.
With early motion to enhance tendon healing, surgery may not be needed after all. Similar results have been shown in other studies for tendon ruptures of the hand.
Bruce C. Twaddle, FRACS, and Peter Poon, FRACS. Early Motion for Achilles Tendon Ruptures: Is Surgery Important? In The American Journal of Sports Medicine. December 2007. Vol. 35. No. 12. Pp. 2033-2038.
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