Discussion:
- posterior splint for 10 days in maximum equinus to reduce tension on the incision;
- cam walker w/ 15 deg of equinus (or gravity equinus), non wt bearing;
- pts are permitted non wt bearing ankle ROM exercises out of the cam walker;
- after approximately 3-4 weeks the leg is brought out of equinus to a neutral positoin;
- gradual wt bearing is allowed at 6 weeks;
- consider
DVT prophylaxis for 6 weeks;
- in the report by M. Speck et al (Am J Sports Med 1998), the authors report on their experience with early full wt bearing;
- authors prospectively evaluated the clinical outcomes of 20 pts w/ early full wt bearing and functional treatment after surgical repair of
acute Achilles tendon rupture;
- patients underwent open repair using a Kessler-type suture and simple apposition sutures;
- postoperative regimen included a plantigrade splint for 24 hours and 6 weeks of early full wt bearing in a removable walker;
- at 1 day after surgery, early full wt bearing alternating with passive range of motion exercises was initiated;
- patients were instructed to move the ankle four times a day between 20° of plantar flexion and 10° of extension;
- there were no reruptures;
- references:
-
Immobilization in neutral versus equinus position after Achilles tendon repair. A review of 32 patients.
- Early Motion of Ankle After Operative Treatment of a Rupture of Achilles Tendon. A Prospective, Randomized Clinical and Xray Study.
NH Maagaard Mortensen, M.D. JBJS Vol 81-A. July 1999.
- Early Full Wt bearing and Functional Treatment After Surgical Repair of Acute Achilles Tendon Rupture.
Matthias Speck MD. American Journal of Sports Medicine. Vol 26 No 6 Nov-Dec 1998
-
Elongation of the Achilles Tendon After Rupture Repair Occurred Slightly Less with Postoperative Early Motion Than with Postoperative Immobilization.
-
Early Motion for Achilles Tendon Ruptures: Is Surgery Important? A Randomized, Prospective Study
-
The Influence of Early Weight-Bearing Compared with Non-Weight-Bearing After Surgical Repair of the Achilles Tendon
