Achilles tendon tendon rupture: motion and weight bearing early after operative treatment

Abstract

Objective: The early motion after surgical treatment of Achilles tendon rupture is a point of controversy in the literature. The goal o this study was to evaluate the functional results of early motion and weight bearing through clinical protocol. Methods: The authors present a study of 36 patients with calcaneus tendon rupture. The patients underwent repair surgery by Krackow´s technique and tendon transfer (peroneus brevis tendon and/or Lynn technique). Immobilization was used up to the 15 day and, after that, an articulated ankle foot orthosis with dorsiflexion blocking was used and full weight bearing was then permitted in the injured ankle, until six week of postoperative. The analysis of the results was based on the clinical exam and on a questionary applied on the latest follow-up. Results: In regard to adherence, it was observed degree 0 in 14 patients and degree I in 2 of them; articulation mobility was equal to the contralateral ankle in all patients; strength of toe-standing was inferior to the contralateral side in 5.16%; mean muscle atrophy was 1.38 cm and mean tendon hypertrophy was 1.05 cm, the patients were back to their daily activities by the nineth week and to the sports activities by the fourth month. All patients were satisfied with their results, except for two of them, one satisfied with a slight restriction and the other with a severe restriction due to sporadic pain in the hipertrophyc scar. Conclusion: The repair of the calcaneus tendon rupture by the Krackow´s technique, associated with peroneus brevis tendon transfer, allowed mobilization and early full weight bearing with strength and function recovery in all patients, with no case of rerupture, presenting satisfying (excellent/good) outcomes in 94.44% of the cases.