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Original articles  SPORT INJURIES AND REHABILITATION


The Journal of Sports Medicine and Physical Fitness 2003 September;43(3):367-79

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

No adverse effect of early weight bearing following open repair of acute tears of the Achilles tendon

Maffulli N. 1, 2, Tallon C. 2, Wong J. 2, Peng Lim K. 2, Bleakney R. 3

1 Department of Trauma and Orthopaedic Surgery Keele University School of Medicine North Staffordshire Hospital, Stoke on Trent Staffordshire, England 2 Department of Orthopaedic Surgery University of Aberdeen Medical School Aberdeen, Scotland 3 Department of Radiology Aberdeen Royal Infirmary, Aberdeen, Scotland


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Aim. To ­study the ­effects of ­early ­weight ­bearing fol­lowing ­acute ­repair of rup­tured ­Achilles ­tendon.
­Methods. ­Using a com­par­a­tive lon­gi­tu­dinal ­study ­design, fol­lowing ­repair of an ­Achilles ­tendon rup­ture, ­patients in ­Group 1 ­were immob­il­ised ­with ­their ­ankle in ­gravity ­equinus, ­were encour­aged to ­weight ­bear on the oper­ated ­limb as ­soon as pos­sible to ­full ­weight ­bearing, and ­received a ­single a ­cast ­change at 2 ­weeks, ­when the ­ankle was immob­il­ised in a plan­ti­grade posi­tion. ­Patients in ­Group 2 ­were immob­il­ised ­with ­their ­ankle in ­full ­equinus, and ­received a ­cast ­change at 2 ­weeks, ­when the ­ankle was immob­il­ised in mid ­equinus, and at 4 ­weeks, ­when the ­ankle was immob­il­ised in a plan­ti­grade posi­tion. ­They ­were ­advised to ­weight ­bear 4 ­weeks ­from the oper­a­tion.
­Results. ­Patients in ­Group 1 ­attended ­less out­pa­tient ­visits, com­pletely dis­carded ­their ­crutches at an ­average of 2.5 ­weeks ­from the oper­a­tion (­Group 2: ­average of 5.7 ­weeks ­from the oper­a­tion), (p=0.013), and a ­greater pro­por­tion of ­them ­were sat­is­fied ­with the ­results of sur­gery. At ultra­sound ­scan, the ­average thick­ness of the ­repaired ­tendon was 12.1 mm (SD 2), ­with no dif­fer­ence in the thick­ness of the rup­tured ­tendon regard­less of the ­method of post­op­er­a­tive man­age­ment. ­There was no sig­nif­i­cant dif­fer­ence in iso­metric ­strength ­between the two ­groups of ­patients.
Con­clu­sion. ­Early ­weight ­bearing ­with the ­ankle plan­ti­grade is not det­ri­mental to the out­come of ­repair fol­lowing rup­ture of the ­Achilles ­tendon.

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