No adverse effect of early weight bearing following open repair of acute tears of the Achilles tendon.
OBJECTIVE
To study the effects of early weight bearing following acute repair of ruptured Achilles tendon.


METHODS
Using a comparative longitudinal study design, following repair of an Achilles tendon rupture, patients in Group 1 were immobilised with their ankle in gravity equinus, were encouraged to weight bear on the operated limb as soon as possible to full weight bearing, and received a single a cast change at 2 weeks, when the ankle was immobilised in a plantigrade position. Patients in Group 2 were immobilised with their ankle in full equinus, and received a cast change at 2 weeks, when the ankle was immobilised in mid equinus, and at 4 weeks, when the ankle was immobilised in a plantigrade position. They were advised to weight bear 4 weeks from the operation.


RESULTS
Patients in Group 1 attended less outpatient visits, completely discarded their crutches at an average of 2.5 weeks from the operation (Group 2: average of 5.7 weeks from the operation), (p=0.013), and a greater proportion of them were satisfied with the results of surgery. At ultrasound scan, the average thickness of the repaired tendon was 12.1 mm (SD 2), with no difference in the thickness of the ruptured tendon regardless of the method of postoperative management. There was no significant difference in isometric strength between the two groups of patients.


CONCLUSIONS
Early weight bearing with the ankle plantigrade is not detrimental to the outcome of repair following rupture of the Achilles tendon.
Maffulli
N
N
Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Stoke on Trent, Staffordshire, England. n.maffulli@keele.ac.uk
Tallon
C
C
Wong
J
J
Peng Lim
K
K
Bleakney
R
R
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000886:Anthropometry; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013708:Tendon Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors; D014463:Ultrasonography; D016474:Weight-Bearing / Q000502:physiology*