[Plaster-free, early functional after-care of surgically managed Achilles tendon rupture]

The widely used treatment of Achilles tendon rupture by operation and postoperative plaster is more and more controversially discussed. The disadvantages of plasters with thrombosis and joint stiffness and recent results about tendon healing makes it worth while to illucinate an immediate functional physiotherapy. Our study consists of two groups of patients who were operated for tendon rupture. Postoperative one group (n = 24) was treated with a plaster for six weeks. The second group (n = 17) was immediately treated by physiotherapy without any immobilisation. After a mean time interval of 19.8 months the joint movement and tendon flexibility was evaluated. Furthermore soft tissue ultrasound was performed to measure the tendon tissue density and gliding movement. Our data showed that 1. Early functional treatment resulted in minor problems (35%) than immobilisation (46%). 2. Plaster-free treated patients had higher tendon density values (grade II 41%, grade III 47%, grade IV 12%), which depicts a higher tensile strength than the comparable group (grade II 29%, grade III 58%, grade IV 13%). 3. Plaster-free treated patients showed significant lesser adhesion formation to the Achilles tendon (grade I 29%, grade II 53%, grade III 18%) than immobilisation (grade I 4%, grade II 59%, grade III 37%).