Article: Achilles tendon rupture

Achilles tendon rupture commonly occurs as an acceleration injury e.g. pushing off or jumping up. Diagnosis is made by clinical history; typically people say it feels like being kicked or shot behind the ankle, and by examination, when a gap may be felt in the tendon, and Simmond's test is positive.

Simmond's test is where on squeezing the calf of the affected side, no movement is elicited in the foot, which would normally be expected to move. Sometimes an ultrasound scan may be required to confirm the diagnosis.

Treatment remains divided between operative and non-operative management. Non-operative management consists of restriction in an "equinus" plaster cast for eight weeks with the foot pointed downwards (to oppose the ends of the ruptured tendon). Some surgeons feel an early surgical repair of the tendon is beneficial. The surgical option offers a slightly smaller risk of re-rupture, but has the attendant risks of surgery i.e. infection, bleeding etc.

Most cases of Achilles tendon rupture are traumatic (caused by injury). The average age of patients is 30-40 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.