Paper| Volume 28, ISSUE 4, P289-292, May 1997

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An audit of the combined non-operative and orthotic management of ruptured tendo Achillis

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      At this institution we have introduced combined non-operative and orthotic treatment for ruptured tendo Achillis. An outcome audit was performed to assess this treatment. Patients were treated in a short-leg cast in the equinus position. After a cast period of 4 weeks, the patient was placed in orthoses for a further 4 weeks, after which they returned to normal activities as was appropriate. We performed a retrospective review including visual analogue scores of patient satisfaction and physical examination. Thirty-two patients were reviewed. The average time from injury to review was 2 years (range 6 months to 5.5 years). There were no significant complications following treatment with no re-ruptures to date. Average visual analogue scores (0–10) were for casts 5.9, orthoses 8.5 and overall outcome 8.3. Of those wishing to return to sporting activities 62 per cent did so within 6.6 months (average). Clinical examination showed no significant difference (P, 0.05) between normal and injured leg in terms of ankle range of movement, tone and subtalar movement. The maximum calf circumference was significantly reduced on the affected side (36.84 cm versus 38.2 cm) as was ankle plantar flexion power. This treatment was liked by patients and is at least as effective as other established methods. Calf power and muscle bulk were reduced in the affected leg and may be improved by including a physiotherapy protocol in the treatment.
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        • Carr AJ
        • Norris SH
        The blood supply of the calcaneal tendon.
        J Bone Joint Surg [Br]. 1989; 71: 100
        • Arner O
        • Lindholm A
        • Orell SR
        Histological changes in subcutaneous rupture of the Achilles tendon: a study of 74 cases.
        Acta Chir Scand. 1958; 116: 484
        • Campbell P
        • Lawton JO
        Spontaneous rupture of the Achilles tendon: pathology and management.
        Br J Hosp Med. 1993; 50: 321
        • Platt H
        Observations on some tendon ruptures.
        Br Med J. 1931; ii: 611
        • Lea RB
        • Smith L
        Non-surgical treatment of tendo-Achilles rupture.
        J Bone Joint Surg [Am]. 1972; 48: 268
        • Stein SR
        • Leukens CA
        Closed treatment of Achilles tendon ruptures.
        Orthop Clin North Am. 1976; 7: 241
        • Nistor L
        Surgical and non-surgical treatment of Achilles tendon rupture.
        J Bone Joint Surg [Am]. 1981; 63: 394
        • Rubin BD
        • Wilson HJ
        Surgical repair of the interrupted Achilles tendon.
        J Trauma. 1980; 20: 248
        • Freunsguard S
        • Helming P
        • Riis J
        • Stovring JO
        Conservative treatment for acute rupture of the Achilles tendon.
        Int Orthop. 1992; 16: 33
        • Novacheck T
        Orthotic management in cerebral palsy.
        Lecture on the Clinical Gait Course. 1995; (Enschede, Holland)
        • Lough LK
        • Knutson LM
        The effects of fixed and hinged ankle foot orthoses on gait myoelectric activity and standing joint alignement in children with cerebral palsy.
        Doctoral Dissertation. 1990; (Iowa Coty, Iowa)
        • Cottalora J
        • Keilberine F
        • Curvale G
        • Groulier P
        Surgical treatment of ruptures of the Achilles tendons in atheletes.
        J Chir. 1992; 129: 436