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A new conservative-dynamic treatment for the acute ruptured Achilles tendon

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

There is a trend towards surgical treatment of acute ruptured Achilles tendon. While classical open surgical procedures have been shown to restore good functional capacity, they are potentially associated with significant complications like wound infection and paresthesia. Modern mini-invasive surgical techniques significantly reduce these complications and are also associated with good functional results so that they can be considered as the surgical treatment of choice. Nevertheless, there is still a need for conservative alternative and recent studies report good results with conservative treatment in rigid casts or braces.

Patients/method

We report the use of a dynamic ankle brace in the conservative treatment of Achilles tendon rupture in a prospective non-randomised study of 57 consecutive patients. Patients were evaluated at an average follow-up time of 5 years using the modified Leppilahti Ankle Score, and the first 30 patients additionally underwent a clinical examination and muscular testing with a Cybex isokinetic dynamometer at 6 and 12 months.

Results

We found good and excellent results in most cases. We observed five complete re-ruptures, almost exclusively in case of poor patient’s compliance, two partial re-ruptures and one deep venous thrombosis complicated by pulmonary embolism.

Conclusion

Although prospective comparison with other modern treatment options is still required, the functional outcome after early ankle mobilisation in a dynamic cast is good enough to ethically propose this method as an alternative to surgical treatment.

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, University Hospital (CHUV), Lausanne, Switzerland

    Felix Neumayer, Elyazid Mouhsine, Yvan Arlettaz, Michael Wettstein & Xavier Crevoisier

  2. Department of Sports Medicine, University Hospital (CHUV), Lausanne, Switzerland

    Gérald Gremion

  3. CHUV Site Hôpital Orthopédique, Pierre-Decker 4, 1011, Lausanne, Switzerland

    Xavier Crevoisier

Authors
  1. Felix Neumayer
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  2. Elyazid Mouhsine
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  3. Yvan Arlettaz
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  4. Gérald Gremion
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  5. Michael Wettstein
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  6. Xavier Crevoisier
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Corresponding author

Correspondence to Xavier Crevoisier.

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Neumayer, F., Mouhsine, E., Arlettaz, Y. et al. A new conservative-dynamic treatment for the acute ruptured Achilles tendon. Arch Orthop Trauma Surg 130, 363–368 (2010). https://doi.org/10.1007/s00402-009-0865-1

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  • DOI: https://doi.org/10.1007/s00402-009-0865-1

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