Achilles tendon rupture

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Background

  • Most frequently ruptures 2-6cm above calcaneus (where blood supply is weakest)
  • Typical pt is 30-50yr old man who participates in strenuous activities on occasional basis

Clinical Features

  • Sudden, severe pain
  • Inability to run, stand on toes, or climb stairs
  • Palpable gap in Achilles tendon 2-6cm proximal to calcaneus
  • Thompson test
    • Lay pt prone w/ knee bent at 90'
    • In normal pt, squeezing calf results in plantarflexion

Treatment

  • Short leg cast w/ ankle slightly plantarflexed
  • Ortho referral

Source

  • Tintinalli