Achilles tendon rupture

Jump to navigation Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
Achilles tendon rupture
MRI: STIR: Achilles tendon rupture
(Image courtesy of RadsWiki)
ICD-10 S86.0
eMedicine sports/1 

WikiDoc Resources for Achilles tendon rupture

Articles

Most recent articles on Achilles tendon rupture

Most cited articles on Achilles tendon rupture

Review articles on Achilles tendon rupture

Articles on Achilles tendon rupture in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Achilles tendon rupture

Images of Achilles tendon rupture

Photos of Achilles tendon rupture

Podcasts & MP3s on Achilles tendon rupture

Videos on Achilles tendon rupture

Evidence Based Medicine

Cochrane Collaboration on Achilles tendon rupture

Bandolier on Achilles tendon rupture

TRIP on Achilles tendon rupture

Clinical Trials

Ongoing Trials on Achilles tendon rupture at Clinical Trials.gov

Trial results on Achilles tendon rupture

Clinical Trials on Achilles tendon rupture at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Achilles tendon rupture

NICE Guidance on Achilles tendon rupture

NHS PRODIGY Guidance

FDA on Achilles tendon rupture

CDC on Achilles tendon rupture

Books

Books on Achilles tendon rupture

News

Achilles tendon rupture in the news

Be alerted to news on Achilles tendon rupture

News trends on Achilles tendon rupture

Commentary

Blogs on Achilles tendon rupture

Definitions

Definitions of Achilles tendon rupture

Patient Resources / Community

Patient resources on Achilles tendon rupture

Discussion groups on Achilles tendon rupture

Patient Handouts on Achilles tendon rupture

Directions to Hospitals Treating Achilles tendon rupture

Risk calculators and risk factors for Achilles tendon rupture

Healthcare Provider Resources

Symptoms of Achilles tendon rupture

Causes & Risk Factors for Achilles tendon rupture

Diagnostic studies for Achilles tendon rupture

Treatment of Achilles tendon rupture

Continuing Medical Education (CME)

CME Programs on Achilles tendon rupture

International

Achilles tendon rupture en Espanol

Achilles tendon rupture en Francais

Business

Achilles tendon rupture in the Marketplace

Patents on Achilles tendon rupture

Experimental / Informatics

List of terms related to Achilles tendon rupture

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Kiran Singh, M.D. [2]


Overview

Achilles tendon rupture is the most common injury involving a break in a tendon. It commonly occurs as a sports injury during explosive acceleration e.g. pushing off or jumping up.

History and Symptoms

Symptoms

  • Acute pain
  • Difficulty walking
  • Referred stabbing pain in the posterior leg and ankle from muscle spasm[1]

Diagnosis

Diagnosis is made by clinical history; typically people say it feels like being kicked or shot behind the ankle. Upon examination a gap may be felt just above the heel unless swelling has filled the gap and the Simmonds' test (aka Thompson test) will be positive; squeezing the calf muscles of the affected side while the patient lies prone, face down, with his feet hanging loose results in no movement (no passive planter flexion) of the foot, while movement is expected with an intact Achilles tendon and should be observable upon manipulation of the uninvolved calf.

An O'Brien test can also be performed which entails placing a sterile needle through the skin and into the tendon. If the needle hub moves in the opposite direction of the tendon and the same direction as the toes when the foot is moved up and down then the tendon is at least partially intact.

MRI

Images courtesy of RadsWiki



Sometimes an ultrasound scan may be required to clarify or confirm the diagnosis. MRI can also be used to confirm the diagnosis.

Risk factors

Most cases of Achilles tendon rupture are traumatic sports injuries. The average age of patients is 30-40 years with a male-to-female ratio of nearly 20:1. Fluoroquinolone antibiotics, such as ciprofloxacin, and glucocorticoids have been linked with an increased risk of Achilles tendon rupture. Direct steroid injections into the tendon have also been linked to rupture.

Treatment

Treatment remains divided between operative and non-operative management. Non-operative management traditionally consisted of restriction in an "equinus" plaster cast for six to eight weeks with the foot pointed downwards (to oppose the ends of the ruptured tendon).

Some surgeons feel an early surgical repair of the tendon is beneficial. The surgical option offers a significantly smaller risk of re-rupture compared to traditional non-operative management (5% vs 15%).[2] However surgery imposes much higher relative risks of perioperative mortality and morbidity e.g. infection including MRSA, bleeding, deep vein thrombosis, lingering anesthesia effects, etc.

References

  1. Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
  2. Richter J, Josten C, Dàvid A, Clasbrummel B, Muhr G (1994). "[Sports fitness after functional conservative versus surgical treatment of acute Achilles tendon ruptures]". Zentralbl Chir (in German). 119 (8): 538–44. PMID 7975942.

External links

de:Achillessehnenruptur


Template:WikiDoc Sources