Achilles Tendon Ijuries

Ammar Eltayeb
• 38- years old man presnt to your clinic with
leg pain for 3 days when he was playing
soccer, suddenly felt aloud popin his
ankle.he turned around to see who had kik
him from behind,but no one was there.His
pain,swellenig and difficult mobility; brought
him to ER next day ,wherethey splint and
gave him medicines for pain,from there he
referred to you.
Educational Messeges
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Examination
 Risk factors
 Recreational athlete , Soccer
[There may be a history of a recent increase in
physical activity/training volume]
 Risk factors
 Obesity

 Diabetes Mellitus
 Previous tendon injury

Previous Steroid
injections
 Acute Rupture

 Feelslike being kicked in the leg

 Acute sever pain
 limping , unable to run,

climb stairs
 No plantar flexion power
 Clinical Test
• Thompson test: with the patient prone, squeezing
the calf of the extended leg may demonstrate no
passive plantar flexion of the foot
 Imaging

o Used to rule out other

pathology
o Avulsion fracture
 MRI

 Not dynamic
 Better at detecting
partial ruptures
 Staging of
degenerative
changes,
 (monitor healing)
 Treatment goals
Optimize gastro-soleous strength and
function
Restore musculotendinous length and
tension.
Avoid ankle stiffness
 POST OP. COMPLICATIONS

•Deep infection (1%)

• Fistula (3%)

• Skin necrosis (2%),

• Rerupture (2%).
 Take home message

o Operative treatment when possible

o young athletic are higher demand patient
o Closed treatment for those patients with limited
functional goals or medical comorbidities
o Functional rehabilitation when possible