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. 2024 Aug;127(8):597-606.
doi: 10.1007/s00113-024-01454-w. Epub 2024 Jul 11.

[Acute rupture of the Achilles tendon : Diagnostics, treatment and aftercare]

[Article in German]
Sebastian Fischer  1
Affiliations

[Acute rupture of the Achilles tendon : Diagnostics, treatment and aftercare]

[Article in German]
Sebastian Fischer. Unfallchirurgie (Heidelb). 2024 Aug.

Abstract
in English, German

With up to 50 incidents per 100,000 inhabitants, Achilles tendon ruptures are among the most frequent tendon injuries encountered in orthopedics and trauma surgery. Apart from high-risk forms of sport, degenerative processes are primarily responsible for weakening and ultimately rupture. In addition to assessing the typical clinical signs with inability to perform powerful plantar flexion, the diagnostics include easy to earn examination techniques, such as the Thompson test and ultrasound as the imaging gold standard. Conservative and surgical treatment are available depending on the constitution, age and requirements of the patient. The latter option is divided into conventional open, minimally invasive or percutaneous procedures. Good to very good results can be expected regardless of the form of treatment, provided that early functional rehabilitation is carried out. The average rerupture rate is 5% and the return to sport rate is around 80%.

Mit bis zu 50 Ereignissen je 100.000 Einwohner ist die Achillessehnenruptur eine der häufigsten Sehnenverletzungen, mit der Orthopäden und Unfallchirurgen konfrontiert werden. Außer risikobehafteten Sportarten sind v. a. degenerative Prozesse für die Schwächung und letztendlich den Riss verantwortlich. Die Diagnostik umfasst neben der Würdigung der typischen klinischen Zeichen mit Unvermögen einer kraftvollen Plantarflexion die leicht zu erlernenden Untersuchungstechniken wie den Thompson-Test und als bildgebenden Goldstandard den Ultraschall. Abhängig von Konstitution, Alter und Anspruch des Patienten stehen die konservative und operative Versorgung zur Verfügung. Letztgenannte Option ist in das konventionell offene, minimalinvasive oder perkutane Vorgehen zu unterteilen. Eine frühfunktionelle Nachbehandlung vorausgesetzt, sind ungeachtet der Versorgungsart gute bis sehr gute Ergebnisse zu erwarten. Die Rerupturrate beträgt im Mittel 5 %, die Rückkehrrate zum Sport rund 80 %.

Keywords: Achillodynia; Conservative treatment; Return to sport; Tendinopathy; Tendon suture.

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References

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