Elsevier

Injury

Volume 29, Issue 9, October 1998, Pages 651-654
Injury

The epidemiology of achilles tendon rupture in a Danish county

https://doi.org/10.1016/S0020-1383(98)00147-8Get rights and content

Abstract

The epidemiology of Achilles tendon ruptures was examined during the 13-year period 1984–1996 in a Danish county. Five hospitals, serving a population of 220,000 cooperated. There were 718 ruptures, 544 men (75.8%) and 174 women (24.2%). The male to female ratio was 3:1. The average age was 42.1 years (3–82) and 62% were between 30–49 years. 74.2% of the ruptures were sport-related and 89% of these occurred in ball and racket games. The annual incidence of achilles tendon ruptures increased from 18.2/105 inhabitants in 1984 to 37.3/105 in 1996. The peak incidence in sport-related ruptures occurred in the age group 30–49 years, but ruptures not related to sport occurred in older patients with a peak incidence in those 50–59 years.

Introduction

The increased interest in recreational sports seems to be followed by an increasing frequency of achilles tendon ruptures, but epidemiological data is still limited1, 2. The purpose of this study was to determine the epidemiology of achilles tendon ruptures with particular emphasis on age and sex distributions and its relation to sport activities in a Danish county.

Section snippets

Patients and methods

The data were collected retrospectively and five hospitals cooperated covering a population of 220,000. Patients with an acute achilles tendon rupture were registered in the Orthopaedic Departments in Esbjerg County Hospital, Grindsted Hospital, Varde Hospital, Ribe Hospital and Brørup Hospital in Ribe County, Denmark.

The data were based on the European home and leisure accident surveillance system (EHLASS) from Esbjerg County Hospital. This is a data base, with information based on case

Definitions and statistics

Incidence is defined as the number of persons affected by the disease annually: (rupture of the achilles tendon) among 100,000 people (inhabitants of Ribe County) during the study period. To estimate if there was a trend in the number of ruptures as associated to time, we calculated a correlation coefficient r as described in standard statistical literature[3]. The Student t-test was applied to test whether this correlation coefficient was significantly different from zero. A significant

Results

718 patients with an acute unilateral achilles tendon rupture were registered for primary treatment. There were 544 men (75.8%) and 174 women (24.2%). The male to female sex ratio was 3:1. The average age for the entire group was 42.1 years (3–82), and 422 patients (62%) were between 30 and 49 years. 643 ruptures (89.6%) were treated operatively and 75 ruptures (10.4%) nonoperatively. The distribution of achilles tendon rupture between the sexes is shown in Table 1.

73% of the ruptures were

Discussion

The incidence of achilles tendon rupture in this study is greater than described in population-based studies in Sweden and Finland1, 2.

As expected achilles tendon ruptures were often associated with sport involving abrupt repetitive jumping and sprinting movements.

More than 70% of the injuries occurred in sporting activities in this study, the most common being badminton, soccer and handball. This is in accordance with previous Danish and other Scandinavian investigations1, 2, 4.

As stated by

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