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Achilles tendon rupture is the most common tendon rupture in the lower extremity. The injury most commonly occurs in adults in their third to fifth decade of life. Acute ruptures often present with sudden onset of pain associated with a "snapping" or audible "pop" heard at the site of injury. Patients may describe a sensation similar to being kicked in the lower leg. Achilles tendon rupture causes significant pain and disability. This activity reviews the etiology, presentation, evaluation, and management of achilles tendon rupture and reviews the role of the interprofessional team in managing it.
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Objectives:Describe risk factors associated with achilles tendon rupture. Explain how the Thompson test is performed and what a positive test suggests.Describe the factors that should be considered when deciding whether to treat with operative versus nonoperative management.Describe how an optimally functioning interprofessional team would coordinate care to enhance outcomes for patients with achilles tendon rupture. Access free multiple choice questions on this topic.
The incidence rates of Achilles tendon ruptures varies in the literature, with recent studies reporting a rate of 18 patients per 100,000 patient population annually. In regard to athletic populations, the incidence rate of achilles tendon injuries ranges from 6% to 18%, and football players are the least likely to develop this problem compared to gymnasts and tennis players. It is believed that about a million athletes suffer from Achilles tendon injuries each year.
The Thompson test is performed by the examiner to assess for achilles tendon continuity in the setting of suspected rupture. The examiner places the patient in the prone position with the ipsilateral knee flexed to about 90 degrees. The foot/ankle are in the resting position. Upon squeezing the calf, the examiner notes for the presence and degree of plantarflexion at the foot/ankle. This should be compared to the contralateral side. A positive (abnormal) test is strongly associated with achilles rupture.
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