Achilles tendon rupture

Question 1

What are the causes of achilles tendon rupture?

Answer 1

Indirect trauma from physical activities (e.g., tennis, basketball)

Risk factors:
(Pre-existing degenerative conditions) including polyarthritis
(↓ Physical conditioning) poor physical condition
(Medication)Local injections of glucocorticoids
Systemic glucocorticoids
Immunosuppressants

Question 2

What are the clinical features of achilles tendon rupture?

Answer 2

Popping or snapping sound/sensation when the injury occurs
Sudden, severe pain in the Achilles tendon
Difficulty mobilising
Calf swelling
palpable interruption of the affected Achille’s tendon
(Simmonds’ test) squeezing the calf (e.g., gastrocnemius muscle) of the patient: Normal - passive plantar flexion
Rupture - no plantar flexion

Simmond’s triad: abnormal angle of declination; gap in the tendon; no dorsiflexion upon calf squeeze)

Question 3

How is achilles tendon rupture diagnosed?

Answer 3

(Mainly clinical, imaging can be done to view extent of injury)
(Ultrasound) best initial test
(X-ray) mainly to rule out suspected bone fractures
(MRI)

Question 4

What is the treatment for achilles tendon rupture?

Answer 4

(Conservative) Rest, analgesia, serial casting
Rehabilitation
(Surgery) Open or percutaneous tendon repair
Casting
Rehabilitation