Abstract

Purpose The aim of the study was to assess the capability of ultrasonography (US) to differentiate between complete and partial rupture of the Achilles tendon by comparing preoperative US with intraoperative findings. Patients and methods We compared US and operative findings in 47 patients with US diagnosis of Achilles tendon rupture. US assessed the continuity and thickness of the tendon and paratendon and the presence of hematoma or bone fragments within the tendon. Results Surgery confirmed complete rupture in all 29 tendons thought to be completely ruptured on US (accuracy = 100%) and confirmed partial rupture in 15 of the 18 tendons thought to be partially ruptured on US (accuracy = 83.3%); the remaining three cases showed retracted tendons with accompanying tendon tear consistent with complete rupture. The characteristic findings for complete tendon rupture were break of the tendon and paratendon, nonvisualization of the tendon, and the presence of gap (hematoma) or bone fragments within the tendon. The characteristic findings for partial tendon rupture were break of the tendon with intact paratendon, intact tendon with internal hypoechogenicity (tear), and tendon thickening. Conclusion US may help to distinguish partial from complete rupture of the Achilles tendon allowing for more appropriate patient management.

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