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

Abstract

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.

Bilateral spontaneous atraumatic rupture of the Achilles tendon in an athlete

“…The literature describes both conservative treatment, with a knee-high cast in equine being used, and surgical treatment. According to our experience and in agreement with the literature, conservative treatment is preferable [12], if there are no contraindications or if the patient is not suitable for casting. American Journal of Emergency Medicine xxx (2015) xxx-xxx 0735-6757/…”

“…Advances in this method, especially with regard to functional bracing of tendons that are well opposed on ultrasound have yielded encouraging results [12,13].…”

Surveying the management of Achilles tendon ruptures in the Netherlands: lack of consensus and need for treatment guidelines

“…We, therefore, consider the 91 responses that we analysed to accurately reflect current ATR management in the Netherlands. This is a higher absolute response number than described by the two other studies that surveyed individual specialists (in the UK) on acute ATR management [15, 19].…”

Bilateral Spontaneous Rupture of the Achilles' Tendon During Chemotherapy Treatment

“…Immobilization is provided by cast or cast-boot, though duration of knee cast use has yet to be clarified. [11] Treatment selection depends upon the patient's age, time of injury, comorbidity, and patient expectations. [12] Surgical treatment is usually preferred in the early period and for younger, active, or athletic individuals.…”