Achilles Tendon Rupture

(OBQ20.16) A 53-year-old man presents to your clinic with posterior ankle pain and weakness during ambulation for 6 months. He wishes to undergo surgical treatment. MRI is shown in Figure A. Which of the following intraoperative findings would most support performing a V-Y lengthening with end-to-end suture repair?

(OBQ19.131) You are reviewing the MRI in Figure A as part of an achilles tendon repair case preparation with your intern. Which of the following structures (A-E) indicates the sural nerve?

(OBQ18.27) A 35-year-old patient presents with right calf weakness of approximately six weeks duration. The patient noted a pop in the back of their heel when carrying a heavy box up a flight of stairs. In the office, there is an approximately 3 cm palpable defect in the posterior heel cord. When examined in the prone position the foot rests in greater dorsiflexion compared to the contralateral. Which procedure will most likely need to be performed at the time of surgical repair?

(OBQ17.192) A 28-year-old male laborer suffered a left ankle injury 4 months ago at work while unloading a dolly. He notes difficulty walking and pain with ambulating. Physical exam shows an inability to toe walk on the left, as well as the finding demonstrated in Figure 1. What other test will be positive and which procedure will likely best result in the restoration of power and function?

(OBQ13.146) A 58-year-old male with a history of chronic posterior ankle pain feels a "pop" and experiences a sharp pain in the back of his heel after jumping off a step. He is placed in a splint and is subsequently lost to follow-up. Six months later he presents complaining of weakness and pain. Examination reveals weakness to ankle plantarflexion and increased passive ankle dorsiflexion. An MRI of his ankle is shown in Figure A. Intraoperatively, a tendon defect a is measured to be 4cm in length. What is the most appropriate treatment plan:

(OBQ13.51) Which of the following outcomes has been reported with surgical repair of acute Achilles tendon ruptures as compared to non-operative treatment with functional rehabilitation?

(SBQ12FA.34) A 55-year-old man has a chronic Achilles tendon rupture. He is scheduled for surgical reconstruction using V-Y advancement of the gastrocnemius-soleus complex aponeurosis with augmentation using a local tendon transfer. What is the native insertion and nerve that innervates the tendon most commonly used to augment this procedure?

(SBQ12FA.20) What would be the most appropriate treatment for the sub-acute injury seen in Figures A-C?

(OBQ12.36) A 36-year-old man presents with fever, pain, and wound drainage 4 months after repair of an acute Achilles tendon rupture. A clinical image is shown in Figure A. Laboratory studies show an ESR of 29 (reference range 0-22 mm/hr). It is decided that he will undergo debridement and irrigation followed by culture specific antibiotic therapy. In the operating room, the Achilles tendon is found to have re-ruptured with a 5 cm defect. What is the most appropriate surgical treatment at this time?

(OBQ10.36) A 58-year-old golfer fell stepping into a sand trap and ruptured his Achilles tendon one year ago. He initially chose non-operative treatment, but became unsatisfied with a tender fullness behind his ankle and ankle weakness noticeable during his tee shots. At the time of surgery, a large disorganized fibrous mass is found at the site of rupture. Following extensive debridement there is a 5 cm gap between viable tissue ends. Which of the following surgical techniques provides the greatest likelihood of a successful clinical outcome?

(OBQ08.269) What is the greatest advantage of surgical repair of an acute Achilles tendon rupture with early range of motion compared to non-operative treatment with immobilization in a short-leg cast for 6 weeks?

(OBQ07.54) A 38-year-old patient has an acute Achilles tendon rupture. He is active in sports and is deciding between operative and nonoperative treatments. Which of the following statements applies to patients undergoing conservative treatment with a cast for 6 weeks followed by a course of physical therapy?

(OBQ06.270) Which factor increases the chance of wound complications after Achilles tendon repair?

(OBQ04.136) A 41-year-old female feels a pop in her ankle while playing tennis. She is diagnosed with an acute Achilles tendon rupture and elects to undergo nonoperative management. Which of the following is the expected outcome seen with nonoperative management with early functional rehabilitation as compared with operative treatment?