[Modified after care following primary management of rupture of the Achilles tendon]

Abstract

During the period ranging from 1975 to 1988, 169 Achilles tendon ruptures were operated on in the Department of Traumatology and Reconstructive Surgery of Steglitz Medical Center, Free University of Berlin. The majority of these ruptures, i.e. 149 cases, were due to sports injuries. In order to comply with our patients' wish for quick rehabilitation, we have altered our follow-up treatment concept since 1982. The surgical technique remained the same in the form of a Bunnell suture with wire or absorbable suture material. There was an initial post-operative immobilization for five to seven days in a dorsal femoral plaster splint at a 30 degree bending position. The ankle joint was immobilized in a neutral position from the start. After approximately one week, the lower leg was put in a walking cast in a neutral position. The patients were allowed to put full load on the leg. After an additional four weeks, the cast was removed and functional follow-up treatment started. The two patient collectives that were compared did not significantly differ with regard to age structure and accident mechanisms or accident causes. Changes in the follow-up treatment resulted in a marked reduction in duration from 14 to 10 weeks. Standing on the toes was likewise possible after 10 weeks. Sports activities could be resumed after four instead of six months, as before. The postoperative rate of complications was low. There were only 10 infections in the total patient collective, one being a deep-wound infection requiring surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)