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Achilles tendon rupture: surgical versus non-surgical treatment
1Accident and Emergency Department, Cavan General Hospital, Cavan, Ireland. drrichard@eircom.net
Objective:
To ascertain the treatment method of choice for Achilles tendon rupture, which results in the most favourable functional outcome.
Methods:
A comprehensive literature search was performed to retrieve relevant English language articles comparing surgical with non-surgical treatment.
Results:
The literature search identified five prospective randomised controlled trials, three of which compare surgical with non-surgical treatment, one which compares functional early mobilisation with cast immobilisation after surgical repair and one which compares functional and cast immobilisation in non-surgical management of Achilles tendon rupture.
Conclusion:
Surgical treatment of Achilles tendon rupture is associated with a significantly lower incidence of re-rupture and therefore is the treatment method of choice. Non-surgical treatment may be acceptable for patients who refuse surgery or who are unfit for surgery. Functional early mobilisation appears to be associated with an improved functional outcome and should be considered in preference to plaster cast immobilisation where appropriate.
