achilles tendon rupture - .achilles tendon rupture acute rupture: a common scenario for achilles

Download Achilles tendon rupture - .Achilles tendon rupture Acute Rupture: A common scenario for Achilles

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AchillestendonruptureAcuteRupture:AcommonscenarioforAchillesruptureoccursinthemiddleagemalewhoundertakesexplosiveactivitysuchasagameofsquash.Bythisagethetendonoftenhasundergonesomedegenerativechangeandmayfailtosustainasuddenstrongresistedmusclecontraction.Thisinjuryhowever,canoccurinanyone.Thefeelingisofbeinghitinthebackofthecalfbyacricketbat.

WhendiagnosedearlyamidsubstanceAchillesrupturecanbetreatedwithoutanoperation.Ideally,ifthetwoendsoftherupturedtendon

canbebroughtintocontactbyplacingtheankleinplantarflexion(pointingthetoe)thenitshouldheal.Theinjurycanalsooccurlowerdownattheinsertionintothecalcaneus(heelbone)orhigheratthemusculotendinousjunctioninwhichcasetheimplicationsmightbedifferentandwillbediscussedatyourconsult.ThesurgicaloptionistohaveanAchillesrepair.Itreducesslightlytheriskofre-ruptureinthefutureandgivesaslightedgeinmaximumsportsperformance.Thisoptioninvolvestheriskofsurgerysuchasinfection,woundbreakdownandnerveinjury.Thesurgerytakesapproximately30minutesandcanbedonethroughanapproximately5cmincision,sometimessmaller.Anacceleratedrehabilitationprogramisusuallyrecommendedregardlessofthechoicebetweensurgeryvsnosurgeryandmustbecloselyadheredtoandbesupervisedbyaphysiotherapist.Aplantarflexioncast(withthetoepointed)isusedinitiallybeforea2weekwoundassessmentandtransitioningtoabootwithaheelraise.ThePhysiotherapistcanthensuperviseyourrehabandyoucanexpecttostartsportspecifictrainingat3monthsbutitisgenerallyrecommendedtotake12monthsofffromseriousrunningandexplosivepushofftypesports.ChronicAchillestendonrupture.TherearesituationswhereanAchillesrupturemaynotbediagnosedandtreatedinthefirstfewweeks.Atthisstagethegapbetweentheendsofthetendoncannotbeclosedwithasimplerepair.Thismayinvolveareconstructiveprocedurewhereextralengthtobridgethegapisgainedfromfurtherupthecalf.ThisinvolvesalargerincisionandbecomesasimilarscenariotothatseeninNonInsertionaltendinopathywhichisexplainedearlierinthisinformationsheet.

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