LONG-TERM RESULTS AFTER SURGICAL-MANAGEMENT OF PARTIAL ACHILLES-TENDON RUPTURES

Although Achilles tendon injuries are common overuse injuries in sport s, the exact incidence is unknown, primarily as a result of varying de finitions and diagnoses of the underlying pathological changes. Despit e numerous studies of treatment of the Achilles tendon injuries, the l ongterm results are not well known. The results after surgical treatme nt of chronic partial Achilles tendon ruptures in 64 patients with a f ollow-up of 6 (1.5-11) years were evaluated in a retrospective study. The ruptures were divided into three groups: (I) proximal (more than 3 cm above the calcaneus), (II) distal and (III) combined (proximal and distal). All patients underwent an operation involving the excision o f the devitalized tendon tissue and, in groups (II) and (III), also th e excision of the deep Achilles bursa and removal of the dorsal corner of the calcaneus, The functional results were satisfactory in 43 (67% ) patients and unsatisfactory in 21 (33%). The results were better in patients with proximal ruptures than in patients with either distal or combined ruptures. Males experienced better results than females. Pos t-operative immobilization in a plaster cast had no significant influe nce on the final result. Nine (14%) patients with either a distal or a combined rupture were re-operated on and in seven of them the final r esult was satisfactory. The conclusion of this study is that partial A chilles tendon ruptures are often difficult to treat and only two out of three patients can be expected to obtain satisfactory results after surgical treatment.