Immediate free ankle motion after surgical repair of acute Achilles tendon ruptures

We prospectively studied 17 consecutively treated patients (15 men and 2 women) who had surgically treated subcutaneous, complete and acute Achilles tendon ruptures. The patients underwent a new postoperative regimen that allowed free ankle motion in a patellar tendon bearing plaster cast with a protecting frame under the foot making weightbearing possible immediately after surgery. Evaluation was done using a patient questionnaire and a clinical examination recorded at 6 weeks (when the mobile ankle cast was removed), 3 months, and 1 year. Measurements of isokinetic and functional strength compared with the uninjured leg were performed at the final followup. No rerupture or other complications occurred. At 1 year, our patients were graded according to the Arner-Lindholm rating scale and there were 15 (88%) excellent, 2 good, and no poor results. Six patients had an excellent result already at 3 months, and there were no poor results at any evaluation. The patient evaluations showed range of motion, strength, and recovery time comparable with or better than results of previous studies. Early free ankle motion after repair of Achilles tendon ruptures proved safe with very satisfactory clinical results, which justified a randomized, prospective study (now in progress) comparing it with traditional ankle immobilization.