Achilles Tear Flashcards
1
Q
ESSENCE
A
Sudden onset injury resulting in loss of achilles tendon and loss of connection between calf muscles (gastrocnemius and soleus) to the heel (calcaneus bone)
2
Q
AETIOLOGY
Risk factors
A
- Sports that stress achilles (eg basketball, tennis and track)
- Age
- Existing achilles tedinopathy
- FH
- Fluoroquinolone antibiotics (eg ciprofloxacin and levofloxacin)
- Systemic steroids
3
Q
AETIOLOGY
What drugs are risk factors
A
- Fluoroquinolone antibiotics
- Systemic steroids
4
Q
CLINICAL FEATURES
Presentation
A
- Sudden onset of pain in achilles or calf
- A snapping sound and sensation
- Feeling as though something has hit them in back of leg
5
Q
CLINICAL FEATURES
Signs on examination
A
- When relaxed in dangled position, affected ankle will rest more dorsiflexed position
- Tenderness in area
- Palpable gap in Achilles
- Weakness of plantar flexion
- Unable to stand on tiptoes
- Positive Simmons calf squeeze test
6
Q
Special test
A
Simmonds calf squeeze test
7
Q
What is simmonds calf squeeze test
A
- Patient positioned prone or kneeling with feet hanging freely at end of bench
- Squeeze calf muscle in leg with intact Achilles there will be plantar flexion of ankle
- Squeeze affected calf and this will not occur, giving positive result
8
Q
INVESTIGATIONS
First choice
A
US - makes diagnosis
9
Q
MANAGEMENT
Options
A
- Immediate management
- Rest and immobilisation
- Ice
- Elevation
- Analgesia
- VTE prophylaxis
- Non-surgical management
- Surgical management
10
Q
MANAGEMENT
Non-surgical
A
- Specialised boot to immobilise ankle
- First boot full plantar flexion
- Overtime altered to gradually move ankle from full plantar flexion to neutral
- Process takes 6-12 weeks
11
Q
MANAGEMENT
Surgical options
A
- Surgical reattaching Achilles
- After surgery boot is used to immobilise ankle and process like non-surgical management occurs
