Achilles Tendon Rupture

Question 1

Type of patient who would get Achilles tendon rupture?

Answer 1

• Middle aged or older

- Usually due to degenerative changes within tendon/recent tendonitis

Question 2

Type of action which could cause an Achilles tendon rupture?

Answer 2

-Sudden deceleration with resisted calf muscle contraction

Eg Lunging at squash

Question 3

Signs/symptoms of Achilles tendon rupture?

Answer 3

• Sudden pain: kicked in back
• Difficult weight bearing
• Weakness of plantar flexion
• Palpable gap in tendon
• Simmonds tests: squeezing calf: no plantar flexion seen

Question 4

What is Simmonds test?

Answer 4

The patient lies face down with feet hanging off the edge of the bed.
If the test is positive, there is no movement of the foot (normally plantarflexion) on squeezing the corresponding calf, signifying likely rupture of the Achilles tendon.

Question 5

Non-operative management of Achilles tendon rupture?

Answer 5

-Series of casts in equinous position: ankle plantarflexed, toes down

Question 6

How do casts in equinous position help?

Answer 6

Closes the gap in torn tendon: over 8 weeks or so

-Avoids potential for wound problems

Question 7

Operative treatment of Achilles tendon rupture?

Answer 7

Suture of damaged tendon

• Restores tension of tendon more accurately
• Repair may have slightly lower re-rupture rate
• Protected by around 8 weeks in casts
• Wound problems