Repair of Neglected Achilles Rupture

Acute Achilles tendon ruptures is routinely missed or undertreated, leading to functional deficits. The neglected Achilles ruptures often requires surgical repair to regain functional improvement. The tendon retraction and resultant necessary debridement of the rupture site leads to difficulty completing end-to-end repair. Advanced techniques, including fascial advancements, tendon transfers, and use of allografts, allow the treating surgeon many viable repair options for the neglected Achilles presentation. The article describes the neglected Achilles tendon, including the nature of the problem, repair options, surgical technique, and a discussion of the surgical outcomes.