CONSERVATIVE FUNCTIONAL THERAPY OF ACHILL ES-TENDON RUPTURE - TREATMENT AND ANALYSIS OF THE RESULTS

In a prospective study in the period from May 1989 to April 1994, 161 patients at the Unfallchirurgische Klinik in Braunschweig were treated for rupture of the Achilles tendon using a conservative functional me thod. A follow-up examination was carried out on 132 patients (81%) af ter an average of 12.6 months. Conservative therapy was indicated if d ynamic ultrasonography showed sufficient adaptation of the rupture. Co ntinuous retention of the adapted tendon fragments was guaranteed by m eans of special footwear that raises the back of the foot (Variostabil ). The average age of the patients was 39.5 years. In 97 cases (73.5%) the injury was caused by sports. In 68 ruptures the dehiscence was co mpensated in plantar flexion. In 48 cases the dehiscence was 1-5 mm, a nd in 16 cases it was between 6 and 10 mm. The average period of hospi talization was 4.8 days (1/19). The period of inability to work was an average of 4 weeks (27.4 days (0/98)). The rupture healed on an avera ge of 9.5 weeks (5.9/23). Complications included seven cases of re-rup ture (5.3%), and, in the course of treatment, four patients (3%) suffe red profound leg vein thrombosis that in one case developed into postt hrombotic syndrome. In two cases there was tendovaginitis of the Achil les tendon. Early functional conservative therapy using the VARIO-STAB IL shoe is a suitable method for treating a newly ruptured Achilles te ndon. When there is a precise indication, the method is equally as goo d as operative therapy, and because of the low complication rate, it i s even preferable.