[Differentiated diagnostics and treatment of Achilles tendon rupture]

Achilles tendon rupture (ATR) is a common injury among middle-aged people who are physically active. A differentiated clinical and sonographic assessment is primarily required to select the optimal treatment. Treatment options include both conservative and surgical methods. In the case of active young patients, there may be a preference for surgical treatment of acute/subacute ATR due to its potential for less loss of strength and enhanced rehabilitation. Minimally invasive surgery (MIS) techniques have reduced the rate of general complications (wound healing disorders, wound infections) compared to open procedures, with a comparable re-rupture rate. Open surgical techniques or reconstructions are the preferred treatment in cases of chronic ATR with defects or muscle atrophy. Conservative treatment and postoperative therapy require stage-specific functional dynamic rehabilitation, which has been shown to lead to better clinical results and a reduction in the re-rupture rate.