GYPSUM-FREE EARLY FUNCTIONAL RETREATMENT OF THE SURGICALLY TREATED RUPTURED ACHILLES-TENDON

The widely used treatment of Achilles tendon rupture by operation and postoperative plaster is more and more controversially discussed. The disadvantages of plasters with thrombosis and joint stiffness and rece nt results about tendon healing makes it worth while to illucinate an immeadete functional physiotherapy. Our study consists of two groups o f patients who were operated for tendon rupture. Postoperative one gro up (n = 24) was treated with a plaster for six weeks. The second group (n = 17) was immeadetely treated by physiotherapy without any immobil isation. After a mean time intervall of 19.8 months the joint movement and tendon flexibility was evaluated. Furthermore soft tissue ultraso und was performed to measure the tendon tissue density and gliding mov ement. Our data showed that 1. Early functional treatment resulted in minor problems (35 %) than immobilisation (46 %). 2. Plaster-free trea ted patients had higher tendon density values (grade II 41 %, grade II I 47 %, grade IV 12 %), which depicts a higher tensile strength than t he comparable group (grade II 29 %, grade III 58 %, grade IV 13 %). 3. Plaster-free treated patients showed significant lesser adhesion form ation to the Achilles tendon (grade I 29 %, grade II 53 %, grade III 1 8 %) than immobilisation (grade I 4 %, grade II 59 %, grade III 37 %).