[Long-term results of surgically treated Achilles tendon ruptures]

The rupture of the Achilles tendon is a frequent sports injury. Between 1978 and 1988 we treated 358 men and 54 women, with an average age of 43 years, for this. In most cases the site of rupture was 3-5 cm proximal to the distal insertion of the tendon. The long-term subjective results of operative treatment of Achilles tendon ruptures (122 patients) were "good" or "very good" on follow-up examination in 85% of cases, and 97% of the patients treated surgically would choose the same therapy in the event of a new rupture. The isokinetic results demonstrated a (9.1%) loss of static and a 16.7% loss of dynamic strength in plantar flexion of the upper ankle joint compared with the healthy side. Ultrasound examination revealed thickening of the tendon itself and of the dorsal paratendon, with alterations in the tendon structure. In spite of the good results, the high rate of complications, 15.1%, shows that new and extensive studies on functional conservative therapy of Achilles tendon rupture are necessary to find whether conservative or operative therapy is better.