Back تمزق وتر أخيل Arabic Přetržení Achillovy šlachy Czech Achillessehnenruptur German Ruptura del tendón de Aquiles Spanish Rupture du tendon d'Achille French קרע בגיד אכילס HE अकिलीज़ टेंडन टूटना Hindi アキレス腱断裂 Japanese Kecederaan tendon Achilles Malay Gescheurde achillespees Dutch
| Achilles tendon rupture | |
|---|---|
| Other names | Achilles tendon tear,[1] Achilles rupture[2] |
 | |
| The achilles tendon | |
| Specialty | Orthopedics, emergency medicine |
| Symptoms | Pain in the heel[3] |
| Usual onset | Sudden[3] |
| Causes | Forced plantar flexion of the foot, direct trauma, long-standing tendonitis[4] |
| Risk factors | Fluoroquinolones, significant change in exercise, rheumatoid arthritis, gout, corticosteroids[1][5] |
| Diagnostic method | Based on symptoms and examination, supported by medical imaging[5] |
| Differential diagnosis | Achilles tendinitis, ankle sprain, avulsion fracture of the calcaneus[5] |
| Treatment | Casting or surgery[6][5] |
| Frequency | 1 per 10,000 people per year[5] |
Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks.[5] Symptoms include the sudden onset of sharp pain in the heel.[3] A snapping sound may be heard as the tendon breaks and walking becomes difficult.[4]
Rupture typically occurs as a result of a sudden bending up of the foot when the calf muscle is engaged, direct trauma, or long-standing tendonitis.[4][5] Other risk factors include the use of fluoroquinolones, a significant change in exercise, rheumatoid arthritis, gout, or corticosteroid use.[1][5] Diagnosis is typically based on symptoms and examination and supported by medical imaging.[5]
Prevention may include stretching before activity and gradual progression of exercise intensity.[4] Treatment may consist of surgical repair or conservative management.[6][2] Quick return to weight bearing (within 4 weeks) appears acceptable and is often recommended.[6][7] While surgery traditionally results in a small decrease in the risk of re-rupture, the risk of other complications is greater.[2] Non-surgical treatment is an alternative as there is supporting evidence that rerupture rates and satisfactory outcomes are comparable to surgery.[2] If appropriate treatment does not occur within 4 weeks of the injury outcomes are not as good.[8]
Achilles tendon rupture occurs in about 1 per 10,000 people per year.[5] Males are more commonly affected than females.[1] People in their 30s to 50s are most commonly affected.[5]
- ^ a b c d "Achilles Tendon Tears". MSD Manual Professional Edition. August 2017. Retrieved 26 June 2018.
- ^ a b c d Ochen Y, Beks RB, van Heijl M, Hietbrink F, Leenen LP, van der Velde D, et al. (January 2019). "Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis". BMJ. 364: k5120. doi:10.1136/bmj.k5120. PMC 6322065. PMID 30617123.
- ^ a b c Hubbard MJ, Hildebrand BA, Battafarano MM, Battafarano DF (June 2018). "Common Soft Tissue Musculoskeletal Pain Disorders". Primary Care. 45 (2): 289–303. doi:10.1016/j.pop.2018.02.006. PMID 29759125. S2CID 46886582.
- ^ a b c d Shamrock AG, Varacallo M (January 2018). "Achilles Tendon, Rupture". StatPearls. PMID 28613594.
- ^ a b c d e f g h i j k Ferri FF (2015). Ferri's Clinical Advisor 2016 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 19. ISBN 9780323378222.
- ^ a b c El-Akkawi AI, Joanroy R, Barfod KW, Kallemose T, Kristensen SS, Viberg B (March 2018). "Effect of Early Versus Late Weightbearing in Conservatively Treated Acute Achilles Tendon Rupture: A Meta-Analysis". The Journal of Foot and Ankle Surgery. 57 (2): 346–352. doi:10.1053/j.jfas.2017.06.006. PMID 28974345. S2CID 3506883.
- ^ van der Eng DM, Schepers T, Goslings JC, Schep NW (2012). "Rerupture rate after early weightbearing in operative versus conservative treatment of Achilles tendon ruptures: a meta-analysis". The Journal of Foot and Ankle Surgery. 52 (5): 622–628. doi:10.1053/j.jfas.2013.03.027. PMID 23659914.
- ^ Maffulli N, Ajis A (June 2008). "Management of chronic ruptures of the Achilles tendon". The Journal of Bone and Joint Surgery. American Volume. 90 (6): 1348–1360. doi:10.2106/JBJS.G.01241. PMID 18519331.