Achilles tendon rupture
Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks. Symptoms include the sudden onset of sharp pain in the heel. A snapping sound may be heard as the tendon breaks and walking becomes difficult.
| Achilles tendon rupture | |
|---|---|
| Other names | Achilles tendon tear, Achilles rupture |
| The achilles tendon | |
| Specialty | Orthopedics, emergency medicine |
| Symptoms | Pain in the heel |
| Usual onset | Sudden |
| Causes | Forced plantar flexion of the foot, direct trauma, long-standing tendonitis |
| Risk factors | Fluoroquinolones, significant change in exercise, rheumatoid arthritis, gout, corticosteroids |
| Diagnostic method | Based on symptoms and examination, supported by medical imaging |
| Differential diagnosis | Achilles tendinitis, ankle sprain, avulsion fracture of the calcaneus |
| Treatment | Casting or surgery |
| Frequency | 1 per 10,000 people per year |
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. Other risk factors include the use of fluoroquinolones, a significant change in exercise, rheumatoid arthritis, gout, or corticosteroid use. Diagnosis is typically based on symptoms and examination and supported by medical imaging.
Prevention may include stretching before activity and gradual progression of exercise intensity. Treatment may consist of surgical repair or conservative management. Quick return to weight bearing (within 4 weeks) appears okay and is often recommended. While surgery traditionally results in a small decrease in the risk of re-rupture, the risk of other complications is greater. Non surgical treatment is an alternative as there are supporting evidences that rerupture rates and satisfactory outcomes are comparable to surgery. If appropriate treatment does not occur within 4 weeks of the injury outcomes are not as good.
Achilles tendon rupture occurs in about 1 per 10,000 people per year. Males are more commonly affected than females. People in their 30s to 50s are most commonly affected.