SPORT ACTIVITIES FOLLOWING FUNCTIONAL AND OPERATIVE TREATMENT OF ACUTE ACHILLES-TENDON RUPTURES

Acute Achilles tendon ruptures are mostly related to recreational acti vities. Therefore, these patients intend to return to sports as soon a s possible with no functional deficiency. This is the first study, com paring functional results after functional treatment to those after su rgery. According to sonographic examinations of the tendon gap, primar y functional treatment with heel supported shoes or surgery were sugge sted. Between 2/1991 and 12/1992, 22 patients with acute Achilles tend on rupture were treated without operation (group 1) and in 10 patient the rupture was sutured (group 2). 6 months later, 27 patients underwe nt standardized clinical examination: one leg standing for one minute, measurement of the circumference of the calf. The actual activities w ere assigned to Tegner Activity Score. 19 patients had isokinetic cybe x testing with 60-degrees/s. There were 3 re-ruptures in group 1 and n o comparable complications in group 2. At this time, clinical examinat ion and Tegner Activity Score showed no relevant differences. Force of flexion was 30.4% lowered in group 1 and 2.4% in group 2. Additional training of the calf muscles improved the results after 6 weeks in gro up 1. We concluded that individual management of acute Achilles tendon rupture is possible according to sonographic tendon gap. Functional t reatment is effective, but the rate of re-ruptures has to be reduced b y careful selection of patients (rupture gap less-than-or-equal-to 2 m m. high cooperation).