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THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
Rivista di Medicina, Traumatologia e Psicologia dello Sport
Indexed/Abstracted in: Chemical Abstracts, CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,111
Original articles SPORT INJURIES AND REHABILITATION
The Journal of Sports Medicine and Physical Fitness 2003 September;43(3):367-79
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
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.