Achilles Tendon Rupture
Type of Procedure: Outpatient
Length of Procedure: One hour
Anesthesia: General and popliteal block
Rupture of the Achilles Tendon: What Is It?
Rupture or tearing of the achilles tendon typically occurs while playing sports or from a misstep. A strong contraction of the muscle excessively loads the tendon and it results in a tear. The patient often describes the sensation that something struck the back of the leg. Pain is suddenly present, and walking is painful and the leg is weak.
While it is possible to treat this ruptured tendon without surgery, this may not be ideal. Surgical correction of the ruptured tendon may be recommendable.
The surgery is performed in order to regain as much as possible the normal strength of the Achilles during push off. Regaining optimum strength depends on establishing the correct tension between the muscle and the tendon.
Following the tendon repair no walking on the foot is permitted for two weeks, then walking is begun in a removable boot. The design of this boot is important, and the positioning of the foot will be controlled in the first several weeks after surgery.
General Recovery Facts
The goal of surgery is to regain strength and function in as short a time as possible. You will need to use crutches for approximately two weeks after surgery. Once the sutures are removed, walking in a removable boot will be started. Walking and exercise are very important to regain strength after surgery and a careful physical therapy program and rehabilitation protocol is outlined below:
- Foot wrapped in bulky bandage and surgical splint
- Ice, elevate, take pain medication
- Expect numbness in foot for 12-24 hours, then pain will increase
- Use crutches for a approximately 2-3 weeks
- First follow up in the office
- Dressing changed, and boot is worn in equines (foot pointed downward)
- Plantarflexion (downward movement of foot) is allowed
- Write out alphabet with foot twice a day
- Start full weight bearing in boot
- If incision is dry, swimming is encouraged at 2 3 weeks
- Gentle exercise on bicycle with boot
- By 6 weeks the boot comes up to a neutral position, with gradual progression to this position completed by the removal of inserts from the boot
- Start physical therapy under supervision
- Gradually wean from boot into open back shoe
- Walking is the most important form of therapy at this point