ACHILLES INJURY - RECREATIONAL ATHLETE

Abstract

HISTORY - A 30-year-old athletic corrections officer felt a painful “pop” in his left heel, while sprinting, during a softball game on 5/21/00. The patient has a history of a complete right Achilles tendon rupture in January of 1999, while playing football. His right tendon was sugically repaired at that time. PHYSICAL EXAMINATION - Swelling and tenderness along the left Achilles tendon. Palpable defect 2cm above the calcaneus. Positive Thompson test. DIFFERENTIAL DIAGNOSIS Partial Achilles Tendon Rupture Complete Achilles Tendon Rupture TEST AND RESULTS NONE FINAL/WORKING DIAGNOSIS Complete left Achilles tendon rupture TREATMENT Conservative Treatment for left Achilles tendon rupture - May 2000 SLC/NWB in gravity equinus, initially SLC/NWB in partial equinus at 3 weeks post injury CAM Walker, progressive weight bearing, ROM exercises at 8 weeks Hinged CAM Walker, calf strengthing exercises at 10 weeks Heel lifts at 12 weeks Return to full activity at 16 weeks post injury. Surgical Treatment for right Achilles tendon rupture - January 1999 Surgical repair, SLC/NWB/Equinus Staples removed, SLC/NWB/dorsiflexion increased by 10 degrees at 10 days post injury SLC/NWB/dorsiflexion increased by second increment of 10 degrees at 4 weeks SLC/Weight bearing as tolerated at 6 weeks Cast removed, physical therapy at 8 weeks Light duty at 12 weeks Return to full activities at 16 weeks post injury OUTCOME The patient had equal functional results with both treatments, but preferred the conservative method over the surgical.