Achilles Tendon Injury Casts

posted on 29 Apr 2015 19:29 by gutturalevidenc75
Overview
Achilles Tendon Having an Achilles Tendon Rupture is no joke. It's not like spraining an ankle or tweaking your back. Rupturing the Achilles Tendon means that a person has significant damage to a huge tendon in their leg. You (generally) can't stand on it if you have a complete rupture (because the tendon totally separates so provides no support) and your calf muscles can roll up into a ball towards the top of your lower leg. It's safe to say that if you have a ruptured Achilles tendon, you'll be getting Achilles tendon surgery very very soon.

Causes
People who commonly fall victim to Achilles rupture or tear include recreational athletes, people of old age, individuals with previous Achilles tendon tears or ruptures, previous tendon injections or quinolone use, extreme changes in training intensity or activity level, and participation in a new activity. Most cases of Achilles tendon rupture are traumatic sports injuries. The average age of patients is 29-40 years with a male-to-female ratio of nearly 20:1. Fluoroquinolone antibiotics, such as ciprofloxacin, and glucocorticoids have been linked with an increased risk of Achilles tendon rupture. Direct steroid injections into the tendon have also been linked to rupture. Quinolone has been associated with Achilles tendinitis and Achilles tendon ruptures for some time. Quinolones are antibacterial agents that act at the level of DNA by inhibiting DNA Gyrase. DNA Gyrase is an enzyme used to unwind double stranded DNA which is essential to DNA Replication. Quinolone is specialized in the fact that it can attack bacterial DNA and prevent them from replicating by this process, and are frequently prescribed to the elderly. Approximately 2% to 6% of all elderly people over the age of 60 who have had Achilles ruptures can be attributed to the use of quinolones.

Symptoms
The pain from an Achilles tendon rupture is usually felt in the back of the lower leg, in the area 2 to 6 cm. above the Achilles tendon's attachment to the calcaneus. Individuals with an Achilles tendon rupture often describe a "pop" or similar feeling at the time of the injury. A "hole" or defect in the Achilles tendon can usually be felt under the skin in this area. A limp and inability to rise up on the toes of the affected foot are usually present. If the affected foot does not plantar flex when the calf muscles are squeezed an Achilles tendon rupture is very likely.

Diagnosis
A staggering 20%-30% of Achilles tendon ruptures are missed. Thompson (calf squeeze) test is 96% sensitive and 93% sensitive. Unfortunately, some health practitioners fail to perform this simple clinical test. Ultrasound examination or an MRI can confirm an Achilles tendon rupture.

Non Surgical Treatment
A medical professional will take MRI scans to confirm the diagnosis and indicate the extent of the injury. Sometimes the leg is put in a cast and allowed to heal without surgery. This is generally not the preferred method, particularly for young active people. Surgery is the most common treatment for an achilles tendon rupture. Achilles Tendon

Surgical Treatment
Surgery offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient?s push-off strength and improves muscle function and movement of the ankle. Various surgical techniques are available to repair the rupture. The surgeon will select the procedure best suited to the patient. Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. The surgeon will determine when the patient can begin weightbearing. Complications such as incision-healing difficulties, re-rupture of the tendon, or nerve pain can arise after surgery. Whether an Achilles tendon rupture is treated surgically or non-surgically, physical therapy is an important component of the healing process. Physical therapy involves exercises that strengthen the muscles and improve the range of motion of the foot and ankle.