تمزق وتر أكيليس في الشيخوخة أو المتطلبات الوظيفية المنخفضة

References

DOI: 10.1302/2046-3758.710.BJR-2018-0004.R2

• Historically, non-surgical treatment always tended to be offered to older patients and those with reduced functional demands, or who had distinct surgical contraindications.
• Therefore, a distance of less than 5 mm is more reliable to confirm adequate apposition of the tendon ends and hence is recommended as the cut-off point for conservative treatment.
• Immobilizing the ankle in equinus for one to three weeks is important in order to allow the haematoma to consolidate and also to restore the continuity of the tendon.
• The most widely used functional protocols combine protected weight-bearing and early controlled movement in an orthosis.
• This begins with a period of immobilization, gradually progressing from the maximum equinus position to a neutral position, using an elevated heel insert to bring the ends of the tendon closer together.
• The authors proposed that a repeat ultrasound examination should be performed two to five days after the initial ultrasound to confirm the indications for nonoperative treatment.