The Achilles tendon is the most powerful tendon of the human body. It is frequently affected by inflamation, degeneration (tendinopathy) and/or rupture.
Unconditioned male individuals, between 30 and 40 years-old, who perform an isolated intense physical activity – “weekend warriors” – are the most frequently affected class.
A strong hit sensation in the posterior part of the ankle is a frequent complaint and may go misdiagnosed as an ankle sprain.
Treatment may be conservative, although active individuals are frequently elected for surgical treatment. Despite the treatment course, early functional rehabilitation is the key for optimizing the outcomes in such cases.
In the left image, classic open repair has been performed. The usual explosive aspect of the acute tendon ruptures can be observed. The correct tensioning, care in the manipulation of the paratendon (image in the right), are crucial for a quick recovery of this injury.
Although rare, partial achilles ruptures may occur, as shown in the picture. It is easily perceived that, despite the rupture is incomplete, the amount of injury will have a functional outcome similar to a complete rupture, thus, treatment options are similar.
In neglected ruptures, the functional impact is severe, presenting with major deficit in gait propulsion strenght, early fatigue, inability to climb and specially getting down the stairs, and also balance impairment.
The are many different treatment options in these cases, such as the V-Y lenghtening of the tendon (present case), or even minimally invasive techniques. Outcomes in these delayed cases are usually inferior to the outcomes of acute ruptures.
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