Dynamised cast management of Achilles tendon ruptures

Non-operative treatment of closed ruptures of the Achilles tendon within 48 h of injury has been shown to produce results comparable with surgical treatment [1,2]. We report 49 patients treated using a dynamised cast, with a mean follow-up of 42 months, in which there has been only one case of re-rupture. A total of 33 patients were reviewed clinically and measurements revealed a mean calf circumference deficit of 1 cm and a mean functional range of ankle motion deficit of 3 degrees and plantar-flexion strength of 81-90%, when compared with the contra-lateral uninjured limb. Early mobilisation of the injured Achilles tendon using a dynamised cast has produced a re-rupture rate and functional recovery that compare favourably with previously published results for patients treated operatively. Non-operative management, in this way, is well tolerated by patients and is of low cost.