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The Journal of Bone and Joint Surgery 82:1804 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Letters to The Editor

Rupture of the Achilles Tendon

Chris J. Bossley, M.B.Ch.B., F.R.C.S.(London), F.R.A.C.S, Bruno Martinelli, Prof, Nicola Maffulli, M.D., M.S., Ph.D., F.R.C.S.(Orth) and Clifford C. Raisbeck, M.D.

Hutt Valley Health Corporation, High Street, Private Bag 31907, Lower Hutt, New Zealand
Department of Orthopaedic Surgery, University of Aberdeen Medical School, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland
Department of Orthopaedic Surgery, University of Aberdeen Medical School, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland
1199 Bush Street, Suite 240, San Francisco, California 94109

To The Editor:

I enjoyed "Current Concepts Review. Rupture of the Achilles Tendon" (81-A: 1019-1036, July 1999) by Nicola Maffulli. I was worried by the complications of conservative treatment of tendo Achillis rupture, and, in 1976, the technique was changed. Patients presenting within twenty-four hours after injury are placed in a below-the-knee, non-weight-bearing, gravity equinus plaster cast. At ten days, the cast is removed and the tendon is examined with the patient lying prone. The swelling will have disappeared, and it will be easy to feel if the tendon is in continuity. If there is no palpable gap, the foot can be gently dorsiflexed. If healing is progressing satisfactorily, the foot will plantar flex slightly when the calf is squeezed. If there is a palpable defect, or if the calf-squeeze test is abnormal, the tendon should be repaired. If healing is satisfactory, a further below-the-knee, weight-bearing, equinus cast is used.

. . . [Full Text of this Article]


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