The treatment of Achilles tendon rupture is controversial between surgical repair and conservative cast treatment. Until the 1970s, treatment of Achilles tendon rupture was predominantly surgical repair, but Lea and Smith reported better results
in
conservative treatment of Achilles tendon rupture and other authors confirmed their good results with cast treatment. This study was attempted to compare the subjective and objective results between operative and conservative treatment of
patients
with
ruptured Achilles tendon.
In a retrospective study, 30 patients with ruptured Achilles tendon were analyzed from January 1990 to May 1994. 15 patients were surgically repaired(group I), and 15 patients were treated with gravity equinus short leg walking cast(group II).
Patients
subjective satisfaction, duration from trauma to normal activity level, plantar flexion power, tendinous healing state checked by ultrasonography, and complications compared, and following results were obtained.
1. All patients satisfied with conservative treatment in group II, while 12 patients were satisfied with operative treatment in group I.
2. The plantar flexion power of injured side was 89% in group I, 87% in group II comparing with uninjured side.
3. Ultrasonographically, mean thickness and ruptured midportion thickness in group II was thicker than those of group I(8.7, 10.6 vs 9.2, 13.2mm), but focal sonolucent area which indicates incomplete healing was observed more in group II than in
group
I(4 vs 2).
4. Three patients had complications in group I-1 rerupture, 1infection and 1 sural nerve injury.
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