Nonoperative treatment of Achilles tendon rupture -: 196 consecutive patients with a 7% re-rupture rate

Background The best treatment for acute Achilles tendon rupture is unknown. Patients and methods We assessed the outcome of nonoperative treatment in 196 consecutive individuals with an acute total Achilles tendon rupture who were followed until healing. The mean duration of treatment in cast or orthosis was 8 weeks. After 4 years, a questionnaire was sent to all patients who were still alive (182) to supplement and confirm the retrospective data. The questionnaire was completed by 176/182 patients (97%). Results The re-rupture frequency was 7% (n = 14). 7 patients suffered other complications (7 deep venous thrombosis and 1 pulmonary embolism). At follow-up, 62% of the patients reported full recovery. Interpretation The low re-rupture rate after nonoperative treatment challenges the claim in recent studies that acute rupture of the Achilles tendon should be operated.