Aim. To lay out a comprehensive protocol for practitioners and physical therapists that has the lowest rerupture rates for nonoperative treatment of acute Achilles ruptures. Method. Relevant articles were searched in PubMed, CINAHL Plus, and Cochrane Library using keyword combinations: nonoperative AND/OR Achilles rupture AND functional AND/OR protocol or functional AND/OR rehabilitation. To be included in the full analysis, the studies had to have detailed functional protocols with physical therapy program details and outcome scores of rupture rates and/or Achilles Tendon Rupture Score (ATRS). We ultimately found 7 articles that fit our inclusion criteria for analysis. All of them had rerupture rates, and 4 had ATRS scores and functional protocols with mention of formal physical therapy programs. Results. Lowest rerupture rates were found in strict functional rehabilitation protocols that were full weightbearing in boot immediately at full equinus or 30° plantar flexed. They started active range of motion at 5 to 8 weeks and started formal physical therapy at 10 weeks. Levels of Evidence: Level III: Evidence obtained from well-designed non-experimental descriptive studies

Level IV: Case series.

Therapeutic, Level IV: Case report.

Bone wax is commonly used in orthopedic procedures for the hemostatic control of cancellous bone bleeding. Herein, ordinary bone wax was used to stop bleeding intraoperatively at the site of a peroneal tubercle resection. Five months postoperatively, a symptomatic retrofibular mass was removed. Gross examination showed severe peroneal tendon destruction associated with the mass. Microscopic examination diagnosed a bone wax granuloma. To our knowledge, this is the first case of significant tendon and nerve damage resulting from a bone wax foreign-body granuloma.

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