Achilles Tendon Rupture

Question 1

What are the risk factors of Achilles tendon rupture?

Answer 1

Sports
Age
Existing Achilles tendinopathy
Family history
Fluoroquinolone antibiotics e.g ciprofloxacin and levofloxacin
Systemic steroids

Question 2

How quickly can Achilles tendon rupture occur after fluoroquinolone antibiotics?

Answer 2

Within 48 hours

Question 3

What is the typical presentation of Achilles tendon rupture?

Answer 3

Sudden onset pain in calf

Snapping sound and sensation

Feeling hit in the back of the leg

Question 4

What are the the signs on examination of Achilles tendon rupture?

Answer 4

When relaxed ankle will rest in a more dorsiflexed position

Tenderness

Palpable gap

Weakness of plantar flexion

Unable to stand on tiptoes on affected leg

Positive Simmond’s calf squeeze (lack of plantarflexion)

Question 5

What investigation is used for confirmation of Achilles tendon rupture?

Answer 5

Ultrasound

Question 6

How is Achilles tendon rupture managed?

Answer 6

Rest and immobilisation

Ice

Elevation

Analgesia

Venous thromboembolism prophylaxis

Question 7

What is the non-surgical management of Achilles tendon rupture?

Answer 7

Boot to immobilises the ankle

First boot involves full plantar flexion of the ankle

Boots are altered to move from full plantar flexion to a neutral position

Occurs over 6-12 weeks

Question 8

What is the surgical management of Achilles tendon rupture?

Answer 8

Surgically reattaching the Achilles

Boot process similar to non-surgical approach