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Achilles Tendon Rupture Print

Achilles Tendon Rupture

It has been known since the time of Hippocrates. Incidence of rupture of the achilles tendon is 0.2% being the most common lower extremity tendon injury.

Etiology

Heel Cord ruture is seen Commonly between 30-40 years old. It is 5 times more common in men. Tendo Achilles rupture occurs more often on the left side.

Sedentary individuals and regular indirect trauma during sporting activity are often observed on clinical history. Sudden unexpected upward movement of the ankle with powerful calf muscle contraction ( or unrecognized step stroke) may be the cause or rupture.

Achilles rupture is more common in the following situations:

Diseases such as Rheumatoid Arthritis, Gout, SLE, renal failure, hypothyroidism, infection, tumors, Quilone group antibiotic usage, corticosteroids, the presence of Achilles tendon complaints (10%)

Patients usually have an assumption that they received a blow from behind, and often hear a sound.

Inability to continue to sports, difficulty in walking, and foot and ankle swelling are the main complaints ans findings. Complaint about pain in patients is rare.

Diagnosis

Physical examination is sufficient in the most of the cases. Fruquent findings  found are:

Foot and ankle edema

a gap felt in the Achilles tendon

Thompson Test +

not being able to tiptoe.

Radiological evaluation reveals following results:

Direct Radiography is helpful particularly in calcaneal avulsion fractures, other associated bony injuries

MRI-suspected situations, particularly in partial Achilles ruptures is valuable.

Treatment

Surgery is the treatment in active young people. Conservative treatment is preferred in elder or physically sedanter patients and in partial heel cord ruptures. Below-knee plaster is done as a conservative treatment. Following plaster removal, physical therapy fastens the recovery.

Surgical technique used in recent days with the most up to date treatment of mini- ivazive / mini-incision (3-4 cm) surgical repair popularizated by Prof.Dr.Şeref Aktaş. In this way, patients  recovery times and operative time are shorter. Results are better with surgical Treatment. Early mobilization is encouraged. Surgical treatment lowers the incidence of  the possibility of recurrent tear and loss of plantar flexion strength of the ankle.

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