Achilles tendon rupture is the tear of the tendon that attaches the calf musculature to the heel bone (calcaneus). This injury occurs in middle-aged men and women who overextend the tendon during physical activity. Most patients state that they felt like someone kicked them in the back of the leg.
Achilles Tendon Ruptures
Causes
-Extended physical activity
-Not giving enough time to rest
-Most common in sports like basketball or running
-Corticosteroid use/injections
-Fluoroquinolone antibiotic use.
-Trauma or fall from height
-Those that have a history of tendonitis
-Arthritis which places excess stress on the tendon
-Tight calf musculature
Symptoms
- A popping sound accompanied by extreme pain in the leg
- Unable to stand, push off the heel, plantarflex the foot
- Bruising/swelling near the heel
- Palpable “dwell” present near the insertion of the Achilles tendon
- No movement noted at the Achilles with the manual squeezing of the calf muscle
Treatment
Xrays/MRI/Ultrasound May be performed to see the location and extend of the damage and to see if there is any bony deformity along with the rupture
Non-surgical options:
This option is reserved for older age, history of arterial disease. Patients are placed in a plantarflexed cast for 6 weeks. Patients are then placed in a cam walker with a gradual return to activity. Physical therapy is usually necessary to return to full activity
Surgical option:
Most cases of Achilles tendon rupture require surgical repair. May different options are present for surgical repair. We prefer to use the minimal incision technique to reapproximate the tendon. In severe cases where there is extensive damage, a tendon transfer may be performed to reinforce the Achilles tendon. We prefer early weight-bearing and range of motion for quicker healing and return to activity.
