title: Conservative treatment for acute Achilles tendon rupture: survey of current practice.
abstract: OBJECTIVE
  To survey the practice of orthopaedic consultants in the Greater London area for treating Achilles tendon ruptures.
  
  
  METHODS
  221 orthopaedic consultants working in 28 hospitals within the Greater London area were identified. A questionnaire regarding conservative treatment for acute Achilles tendon ruptures was sent. The choice of immobilisation, the period of immobilisation, the time to weight bearing, the use of heel raises, and the use of diagnostic ultrasonography were enquired about.
  
  
  RESULTS
  62 of 86 respondents treated Achilles tendon ruptures conservatively by below-knee casts (n=51), above-knee casts (n=5), or functional braces (n=6). The most common immobilisation regimen (n=7) was to keep the foot in a sequence of an equinus position, a semi-equinus position, and a neutral position (3 weeks in each position). After cast removal, 45 of respondents preferred to use a heel raise for a median duration of 4 (range, 2-36) weeks. Respectively for foot and ankle specialists (n=24) and other orthopaedic specialists (n=38), the median immobilisation period prescribed was 8 (range, 3-13) and 9 (range, 6-36) weeks, respectively (p=0.625), whereas the median time to weight bearing prescribed was 6 (range, 0-9) and 6 (range, 0-12) weeks, respectively (p=0.402).
  
  
  CONCLUSIONS
  Functional bracing was not as widely used as below-knee cast immobilisation. There was no consensus on the optimal immobilisation regimen.
authors: University Hospital Lewisham, London, United Kingdom. donaldosaru@btinternet.com
authors: Donald
authors: D
authors: Osarumwense
authors: Jonathan
authors: J
authors: Wright
authors: Kikachukwu
authors: K
authors: Gardner
authors: Laurence
authors: L
authors: James
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D006801:Humans; D009985:Orthopedics; D010818:Practice Patterns, Physicians'; D012421:Rupture / Q000628:therapy; D011795:Surveys and Questionnaires
keywords: Achilles tendon; disease management; questionnaires; tendon injuries