Abstract
Fresh Achilles tendon ruptures in patients with a good physical Condition. Age alone should not be a contraindication. Contraindications for open repair include peripheral arterial diseases, advanced biological age, bad skin and soft tissue conditions and poorly controlled diabetes mellitus.
Many repair and suture techniques are described (end-to-end Bunnell suture, Krakow-type suture and modified Kirchmair-Kessler suture). Open or minimally invasive repair of the tendon could be performed.
Open Achilles tendon repair is the standard technique to achieve a secure repair with subsequent lower risk of re-rupture. The treatment of choice among the different surgical techniques (open, minimally invasive or percutaneous) should be tailored to the patients’ needs and general condition.
-
Symptom specific history: Patients are usually between 30 and 50 years old, playing sport on a recreational basis and reporting a preceding intense training session. Men are affected more often than women (ratio 12 : 1). Positive history of fluoroquinolone intake or steroid injection.
-
Symptom specific Examination: a palpable defect could be felt in many cases and denotes a complete tear of the Achilles tendon. Reactive Thompson test: absent or very weak planter flexion of the foot with passive compression of the calf muscles in prone position. Knee flexion test: the patient lies in prone position and asked to flex the knee to 90°. A tear of the Achilles tendon is probable if the foot spontaneously falls into neutral or slight dorsiflexion.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
References to Chapter 22.1
Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P (2002) Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter stud. J Bone Joint Surg Am 84‐A:161–170
Khan RJ, Carey Smith RL (2010) Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Syst Rev CD003674
Krahe MA, Berlet GC (2009) Achilles tendon ruptures, re rupture with revision surgery, tendinosis, insertional and disease. Foot Ankle Clin 14: 247‐275
Rosenzweig S, Azar FM (2009) Open repair of acute Achilles tendon ruptures. Foot Ankle Clin 14: 699‐709
References to Chapter 22.2
Khan RJ, Carey Smith, RL (2010) Surgical interventions for treating acute Achillestendon ruptures. Cochrane Database Syst Rev CD003674
Krahe MA, Berlet GC (2009) Achilles tendon ruptures, re‐rupture with revisionsurgery tendinosis, and insertional disease. Foot Ankle Clin 14(247):275
Maffulli N, Ajis A (2008) Management of chronic ruptures of the Achilles tendon. J Bone Joint Surg Am 90:1348–1360
Rosenzweig S, Azar FM Open repair of acute Achilles tendon ruptures. FootAnkle Clin 14 (2009) :699‐709
References to Chapter 22.3
Maffulli N, Sharma P, Luscombe KL (2004) Achilles tendinopathy: aetiology andmanagement. J R Soc Med 97: 472‐476
Maffulli N, Testa V, Capasso G, Bifulco G, Binfield PM (1997) Results of percutaneouslongitudinal tenotomy for Achilles tendinopathy in middle‐andlong‐distance runners. Am J Sports Med 25: 835‐840
Murphy, GA (2009) Surgical treatment of non‐insertional Achilles tendinitis. FootAnkle Clin 14: 651‐661
Rompe JD, Furia JP, Maffulli N (2008) Mid‐portion Achilles tendinopathy‐currentoptions for treatment. DisabilRehabil 30:1666–1676
References to Chapter 22.4
Myerson MS, McGarvey W (1999) Disorders of the Achilles tendon insertion andAchilles tendinitis. Instr. Course Lect 48: 211‐218
Sammarco GJ, Taylor, AL (1998) Operative management of Haglund’s deformityin the nonathlete: a retrospective study. Foot Ankle Int 19: 724‐729
Stephens MM (1994) Haglund’s deformity and retrocalcaneal bursitis. OrthopClin North Am 25: 41‐46
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Hofstätter, S., Schuh, R., Trnka, HJ. (2015). Achilles Tendon. In: Imhoff, A., Feucht, M. (eds) Surgical Atlas of Sports Orthopaedics and Sports Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43776-6_22
Download citation
DOI: https://doi.org/10.1007/978-3-662-43776-6_22
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-43775-9
Online ISBN: 978-3-662-43776-6
eBook Packages: MedicineMedicine (R0)