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Achilles Tendon Rupture

Tendon Achilles Rupture of


Presentation

  • In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations.[ncbi.nlm.nih.gov]
  • From the results in the present study, we would recommend early weightbearing when an Achilles tendon rupture is treated conservatively.[ncbi.nlm.nih.gov]
  • Patients with this affliction frequently present weeks to months after the rupture occurs because there is no succinct traumatic event.[ncbi.nlm.nih.gov]
  • In the case presented, nonoperative treatment led to a successful outcome. LEVEL OF EVIDENCE: Therapeutic, Level IV, retrospective case study.[ncbi.nlm.nih.gov]
  • We presented imaging findings of 4 years follow up of the spontaneous partial rupture of Achilles tendon presenting with giant expanding hematoma and mimicking complete rupture radiologically.[ncbi.nlm.nih.gov]
Soft Tissue Mass
  • No soft-tissue masses, bone formation or tumors were observed in the operative extremity.[ncbi.nlm.nih.gov]
Chronic Infection
  • The authors present a successful case of reconstruction of a chronically infected Achilles tendon in an otherwise healthy 43-year-old man via a multistaged approach using the flexor hallucis longus and peroneus brevis tendons.[ncbi.nlm.nih.gov]
Aspiration
  • Positive results using stem-cell-bearing concentrates have been reported with other soft-tissue repairs, but no studies exist on outcomes of bone marrow aspirate concentrate (BMAC) augmentation in primary Achilles tendon repair.[ncbi.nlm.nih.gov]
  • Platelet Rich Plasma (PRP) mixed with stem cells with Bone Marrow Aspiration , (BMA) can be wrapped around the tendon. A special graft material can get wrapped around the tendon. Amniox regenerative tissue can be wrapped around the tendon.[footanklespecialtygroup.com]
  • Surgeons may utilize biologics, including acellular matrices and bone marrow aspirate/stem cells, with any of the techniques to increase healing potential.[podiatrytoday.com]
Protein S Deficiency
  • MTP pulse therapy in a lupus patient with hypercoaguable state with hyperhomocysteinemia, protein S deficiency and high titer antiphospholipid antibodies may cause spontaneous tendon rupture.[ncbi.nlm.nih.gov]
Heel Pain
  • She also had right heel pain and had received multiple steroid injections at the knee joint and heel.[ncbi.nlm.nih.gov]
  • On day 15 after pulse therapy, acute onset of right heel pain occurred when she was ascending stairs. Rupture of the right Achilles tendon was demonstrated by sonography and MRI.[ncbi.nlm.nih.gov]
  • General complications were 5 deep venous thromboses, 1 complex regional pain syndrome, and minor problems such as transient heel pain (n 3), heel numbness (n 1), and cast-associated skin abrasions (n 4).[ncbi.nlm.nih.gov]
  • Patients often complain of heel pain and a sensation that someone struck the back of their leg or they were “shot” in the heel when a tear occurs. A "pop" or “explosion” is frequently felt when the tendon ruptures.[rothmaninstitute.com]
  • If you feel a "pop" sensation in your heal or experience a lot of heel pain, you might have a rupture.[philly.com]

Workup

  • Differential Diagnoses Achilles tendinosis Calf strain Deep vein thrombosis of leg Ankle arthritis Lab Studies Not required for diagnosis but may be done for workup for surgery or to rule out other conditions.[boneandspine.com]
  • […] ultrasonography can identify a ruptured Achilles tendon or the signs of tendinosis Magnetic resonance imaging (MRI): MRI can facilitate definitive diagnosis of a disrupted tendon and can be used to distinguish between paratenonitis, tendinosis, and bursitis See Workup[emedicine.com]

Treatment

  • RESULTS: Average treatment costs in the year after initial diagnosis were higher for patients who underwent initial surgical treatment than for patients who underwent nonsurgical treatment ( 4,292 for surgical treatment versus 2,432 for nonsurgical treatment[ncbi.nlm.nih.gov]
  • In 6/198 patients, the non-operative treatment had to be converted to surgical treatment in the early phase.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: The proportion of patients who received operative treatment for an acute Achilles tendon rupture increased slightly during the 5 year period, suggesting that surgeons in the United States have been slower to adopt nonoperative treatment than[ncbi.nlm.nih.gov]
  • KEYWORDS: complication; conservative treatment; functional outcome; rehabilitation; surgical treatment[ncbi.nlm.nih.gov]
  • OBJECTIVE: There is discordance in the results from meta-analyses on surgical versus non-surgical treatment for acute Achilles tendon rupture.[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis Achilles tendon injury has a good prognosis but the slight loss of function may be very significant for the competitive athlete.[patient.info]
  • Ruptured Achilles Tendon Prognosis You will normally be in your CAM brace for between 6 to 12 weeks. If everything goes perfectly during your rehabilitation it takes at least 12 weeks before a return to sport is possible.[physioworks.com.au]
  • Prognosis of Achilles Tendon Rupture The majority of people return to normal activity levels with either surgical or nonsurgical treatment. Many studies indicate a better outcome with surgery, especially in younger patients.[emedicinehealth.com]
  • Wear proper fitting shoe wear Prognosis of Achilles Tendon Rupture The tendon does take six to eight week and more time is needed for rehabilitation. Usually one can take 4 to 12 months before return to sport or previous activity level.[boneandspine.com]

Etiology

  • The proposed etiologies include nonabsorbable suture granuloma formation, alteration of the pain receptors threshold in the tendon, and distension of the paratenon by the hypertrophied tendon, underlying tendinopathy, postrepair neovascularization, and[ncbi.nlm.nih.gov]
  • Achilles tendon rupture: a review of etiology, population, anatomy, risk factors, and injury prevention. Foot Ankle Spec . 2010;3(1):29-32. Chiodo CP, Glazebrook M, Bluman EM et al. J AM Acad Orthop Surg . 2010;18(8):503-510. Simmonds FA.[westjem.com]
  • The etiology of Achilles tendon rupture is multifactorial, but the injury occurs most frequently in the athletic population.[lermagazine.com]
  • Achilles Tendon ICD-10 codes A initial encounter , D subsequent encounter , S sequela Achilles Tendon Rupture ICD-9 727.67 (Rupture of tendon, nontraumatic; Achilles tendon) 845.09 (Sprain and strain of ankle and foot; Achilles tendon) Achilles Tendon Etiology[eorif.com]
  • There is strong male over-representation presumably as a result of the predominantly sport related etiology.[radiopaedia.org]

Epidemiology

  • There have been no previous reports of Achilles tendon rupture with Nintendo Wii usage; it is a relatively uncommon mode of injury and is rare in terms of epidemiology of motion sensing video game injuries. 2014 BMJ Publishing Group Ltd.[ncbi.nlm.nih.gov]
  • Epidemiology of basketball and netball injuries that resulted in hospital admission in Australia, 2000-2004. Med J Aust 2009;190(2):87-90. Davis JJ, Mason KT, Clark DA.[lermagazine.com]
  • Epidemiology Achilles tendinopathy typically affects athletes; long-distance runners have a lifetime risk of 52%.[patient.info]
  • Tendon ICD-10 codes A initial encounter , D subsequent encounter , S sequela Achilles Tendon Rupture ICD-9 727.67 (Rupture of tendon, nontraumatic; Achilles tendon) 845.09 (Sprain and strain of ankle and foot; Achilles tendon) Achilles Tendon Etiology / Epidemiology[eorif.com]
Sex distribution
Age distribution

Pathophysiology

  • There was no obvious underlying disease or pathophysiological factor causing fragility of his Achilles tendons.[ncbi.nlm.nih.gov]
  • "Tendinopathy: Update on Pathophysiology." Journal of Orthopaedic & Sports Physical Therapy . 2015; 45(11) : 833-841.[orthopedics.about.com]
  • Pathophysiology Achilles tendonitis was the term originally used to describe the spectrum of tendon injuries ranging from inflammation to tendon rupture, but it now is seen as more of a garbage term.[emedicine.com]

Prevention

  • CONCLUSION: The posterolateral skin incision, not above the tendon, preserves the vascularity of the soft tissues, allows identifying and not accidentally injuring the sural nerve, and prevents the cutaneous scar is overlapped the tendon.[ncbi.nlm.nih.gov]
  • Prevention To reduce your chance of developing Achilles tendon problems, follow these tips: Stretch and strengthen calf muscles. Stretch your calf until you feel a noticeable pull but not pain. Don't bounce during a stretch.[mayoclinic.org]
  • RELATED: What it Takes to Recover From an Achilles Injury Prevention Prevention of Achilles tendon injuries can be difficult if you do not display any symptoms.[stack.com]
  • Wrap the foot and ankle in an elastic bandage to prevent further swelling. Elevation. Keep the leg elevated to reduce the swelling. It should be even with or slightly above heart level.[foothealthfacts.org]
  • To prevent injury when starting a new exercise regime, gradually increase the intensity of your exercise and the length of time you spend exercising.[global.ihi.com]

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