Review Question - QID 1241

Recent studies have demonstrated no significant difference in functional outcomes or the rate of re-rupture with treatment of Achilles tendon ruptures when nonoperative management consists of early functional rehabilitation.

Chiodo et al conducted a systematic review of the available evidence for treatment of acute Achilles tendon ruptures. The authors state that both surgical and non surgical treatments as management of Achilles tendon injuries were graded as weak recommendations.

Soroceanu et al conducted a meta-analysis of randomized control trials comparing surgical versus non-surgical management of patients with acute Achilles tendon ruptures. In those studies utilizing functional rehabilitation, there was no significant difference in rates of re-rupture when compared with operative treatment.

Willits et al conducted a prospective randomized control study comparing nonoperative treatment with early functional rehabilitation and operative treatment. The primary outcome measure was re-rupture. The authors found so significant difference in re-rupture or any of the secondary outcome measures when comparing the two treatment protocols.

Incorrect Answers:
Answer 1: No difference is seen in DVT rates between the two treatments
Answer 3: Early functional rehabilitation has been shown to lead to similar rates of re-rupture
Answer 4: Earlier return to sport has not been shown when comparing the two treatments
Answer 5: Complication rates are increased with operative treatment. Complications seen with surgical treatment include infection, wound failure and sural nerve injury.