A recent article in the Journal of Bone and Joint Surgery (our main academic journal) recently confirmed our discussion about non operative treatment of Achilles tendon ruptures. That is, many if not all ruptures of the Achilles tendon can be treated without surgery. The technique involves early immobilization in a cast with the foot plantar flexed (pointed downward), followed by early weight-bearing in a brace and controlled motion. This techniques opposed the ruptured ends of the tendon to each other by plantarflexion and then protected weight-bearing allowed earlier healing.
The results confirmed the results of earlier European studies and also found a low re-rupture rate in those treated without surgery, and a higher complication rate (mostly wound issues ) in those treated surgically. It would appear that either operative or non operative treatment works by putting the ends of the tendon together and allowing them to heal in a protected environment. This article reaffirms the soundness of either operative or non operative care if done in a well thought our and executed manner.
