Acute and chronic Achilles tendon ruptures - current diagnostic and therapeutic options

This review presents information on the epidemiology and current trends in the diagnosis and therapy of acute and chronic Achilles tendon ruptures in middle-aged and elderly patients. Epidemiological data show an increasing incidence of ruptures among the entire population, especially in patients over 65 years of age. Dynamic sonography has become the gold standard diagnostic assessment, facilitating even therapeutic decision- making. The well established conservative-functional therapy can in indicated cases achieve results comparable to those of surgical treatment. Minimally invasive suture techniques using aiming devices reduce the risk of surgical damage and soft tissue complications, particularly in noncompliant patients and patients with restricted perfusion. Reconstruction of chronic tendon ruptures is mostly performed using static techniques, especially the combination of V-Y plasty and fascial flaps. In addition to reruptures and infections, the currently discussed complications also include deep vein thrombosis where a more generous indication scheme of thromboprophylaxis is under consideration.