Early weightbearing and ankle mobilization after open repair of acute midsubstance tears of the achilles tendon.
OBJECTIVE
To study the effects of early weightbearing and ankle mobilization after acute repair of ruptured Achilles tendon.


METHODS
Comparative longitudinal study.


METHODS
Patients in group 1 were postoperatively immobilized with their ankle in gravity equinus, they were encouraged to bear weight on the operated limb as soon as possible to full weightbearing, and they received a single cast change at 2 weeks, with the ankle accommodated in an anterior splint in a plantigrade position, allowing the ankle to be plantar flexed fully but not dorsiflexed above neutral. Patients in group 2 were immobilized with their ankle in full equinus with a cast change at 2 weeks, when the ankle was immobilized in mid equinus, and at 4 weeks, when the ankle was immobilized in a plantigrade position, and they were advised to bear weight.


RESULTS
Patients in group 1 attended fewer outpatient visits, completely discarded their crutches at an average of 2.5 weeks, and more were satisfied with the results of surgery. At ultrasonography, the average thickness of the repaired tendon was 12.1 mm, with no difference in the thickness of the ruptured tendon regardless of postoperative management. There was no significant difference in isometric strength between the two groups.


CONCLUSIONS
Early weightbearing with the ankle plantigrade is not detrimental to the outcome of repair after acute rupture of the Achilles tendon and shortens the time needed for rehabilitation. However, strength deficit and muscle atrophy are not prevented.
Maffulli
Nicola
N
Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Hartshill, Stoke on Trent, Staffordshire, England.
Tallon
Cheryl
C
Wong
Jason
J
Lim
Kim Peng
KP
Bleakney
Robert
R
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000842:Ankle / Q000502:physiology*; D002370:Casts, Surgical; D005260:Female; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy; D019637:Orthopedic Procedures; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D012421:Rupture / Q000534:rehabilitation; D016896:Treatment Outcome; D016474:Weight-Bearing