Functional and early weight-bearing protocol for achilles tendon ruptures: a retrospective study

The Achilles tendon: Management of acute and chronic conditions

“…The risk of rerupture is higher in elderly patients with a degenerative tendon because of the inherent poor quality and diminished vascular supply of the tendon fibres. 5 In the younger population, histological studies performed on acute Achilles tendon ruptures have shown clear degenerative changes despite little or no symptoms pre-injury. 6 Patients who sustain an acute Achilles tendon rupture often describe a 'gunshot' sensation to the back of the leg.…”

“…15 To reduce the risk of functional lengthening (in which the tendon heals in an elongated position causing long-term weakness), patients need to be placed in a plantarflexed cast, backslab or removable orthosis with a heel wedge to force the ankle into plantarflexion as early as possible. 5 Common removable orthoses include a controlled ankle motion (CAM) boot (Figure 3). Ideally the patient is placed in a cast or boot in the emergency department setting within hours of the injury occurring.…”