An audit of the combined non-operative and orthotic management of ruptured tendo Achillis

Eames, Michael; Eames, Niall; McCarthy, Kelsey; Wallace, R. G. H.

doi:10.1016/s0020-1383(96)00203-3

Cited by 21 publications

(14 citation statements)

References 5 publications

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“…Previous publications by the senior author (RGHW) have shown early excellent functional results on formal objective testing. 30,31 Our results demonstrate extremely low rates of rerupture and complications in patients followed-up for at least two years. There was no difference in the re-rupture rate in those with regular sporting demands.…”

Section: Discussionmentioning

confidence: 55%

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The non-operative functional management of patients with a rupture of the tendo Achillis leads to low rates of re-rupture

Wallace

Heyes

Michael

2011

The Journal of Bone and Joint Surgery. British volume

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Controversy surrounds the most appropriate treatment method for patients with a rupture of the tendo Achillis. The aim of this study was to assess the long term rate of re-rupture following management with a non-operative functional protocol. We report the outcome of 945 consecutive patients (949 tendons) diagnosed with a rupture of the tendo Achillis managed between 1996 and 2008. There were 255 female and 690 male patients with a mean age of 48.97 years (12 to 86). Delayed presentation was defined as establishing the diagnosis and commencing treatment more than two weeks after injury. The overall rate of re-rupture was 2.8% (27 re-ruptures), with a rate of 2.9% (25 re-ruptures) for those with an acute presentation and 2.7% (two re-ruptures) for those with delayed presentation. This study of non-operative functional management of rupture of the tendo Achillis is the largest of its kind in the literature. Our rates of re-rupture are similar to, or better than, those published for operative treatment. We recommend our regime for patients of all ages and sporting demands, but it is essential that they adhere to the protocol.

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Section: Discussionmentioning

confidence: 55%

“…[23][24][25][26][27][28][29] Our early results from managing ruptures of tendo Achillis with combined conservative and orthotic treatments were encouraging in both objective and subjective testing. 30,31 The aim of this paper is to examine the long term rates of re-rupture of the non-operative functional treatment of patients with tendo Achillis rupture.…”

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confidence: 99%

The non-operative functional management of patients with a rupture of the tendo Achillis leads to low rates of re-rupture

Wallace

Heyes

Michael

2011

The Journal of Bone and Joint Surgery. British volume

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“…6,11 Nonetheless, there is no consensus on the immobilisation period for each of the 3 positions. 4,[12][13][14][15] In the current study, most respondents preferred to prescribe below-knee cast immobilisation followed by heel raises after cast removal. This was also consistent with a postal questionnaire study on immobilisation following operative treatment.…”

Section: Discussionmentioning

confidence: 79%

Conservative Treatment for Acute Achilles Tendon Rupture: Survey of Current Practice

Osarumwense

Wright

Gardner

et al. 2013

J Orthop Surg (Hong Kong)

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purpose. To survey the practice of orthopaedic consultants in the Greater London area for treating Achilles tendon ruptures. Methods. 221 orthopaedic consultants working in 28 hospitals within the Greater London area were identified. A questionnaire regarding conservative treatment for acute Achilles tendon ruptures was sent. The choice of immobilisation, the period of immobilisation, the time to weight bearing, the use of heel raises, and the use of diagnostic ultrasonography were enquired about. results. 62 of 86 respondents treated Achilles tendon ruptures conservatively by below-knee casts (n=51), above-knee casts (n=5), or functional braces (n=6). The most common immobilisation regimen (n=7) was to keep the foot in a sequence of an equinus position, a semi-equinus position, and a neutral position (3 weeks in each position). After cast removal, 45 of respondents preferred to use a heel raise for a median duration of 4 (range, 2-36) weeks. Respectively for foot and ankle specialists (n=24) and other orthopaedic specialists (n=38), the median immobilisation period prescribed was 8 (range, 3-13) and 9 (range, 6-36) weeks, respectively (p=0.625), whereas the median time to weight bearing prescribed was 6 (range, 0-9) and 6 (range, 0-12) weeks, respectively (p=0.402). conclusion. Functional bracing was not as widely used as below-knee cast immobilisation. There was no consensus on the optimal immobilisation regimen.

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“…This regimen combines the advantages of a removable orthosis with those of traditional nonoperative therapy. The early results, in the first thirty-two patients to be treated with the regimen, were encouraging 14 .…”

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confidence: 95%

Combined Conservative and Orthotic Management of Acute Ruptures of the Achilles Tendon

Wallace

Traynor

Kernohan

et al. 2004

The Journal of Bone and Joint Surgery-American Volume

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Background: There has been considerable debate about the best treatment for acute rupture of the Achilles tendon. At our institution, a well-documented and structured program of nonoperative management of Achilles tendon rupture with use of casts and a removable orthosis was developed. Methods: We assessed the results in 140 consecutive patients with a complete rupture of the Achilles tendon who had been treated with our nonoperative regimen at our center between 1992 and 1998. Patients were evaluated on the basis of the subjective results and clinically with physiological testing. Results: Overall, 56% of our patients had an excellent result; 30%, good; 12%, fair; and 2%, poor. The overall complication rate was 8%, with three complete and five partial tendon reruptures, two deep vein thromboses, and one temporary dropfoot. Conclusions: The results of our nonoperative orthotic treatment were better overall than published results of operative repair of acute Achilles tendon rupture. Our patients were quite satisfied with their treatment. Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

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An audit of the combined non-operative and orthotic management of ruptured tendo Achillis

Cited by 21 publications

References 5 publications

The non-operative functional management of patients with a rupture of the tendo Achillis leads to low rates of re-rupture

The non-operative functional management of patients with a rupture of the tendo Achillis leads to low rates of re-rupture

Conservative Treatment for Acute Achilles Tendon Rupture: Survey of Current Practice

Combined Conservative and Orthotic Management of Acute Ruptures of the Achilles Tendon

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