(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: The Achilles tendon is located at the back of the human ankle and can withstand relatively high tension, which is generally difficult to rupture in daily life. In this paper, the patient came to the clinic because he could not stand on his tiptoes for 1 day after playing badminton bouncing. After related examination, the patient recovered normal walking through Achilles tendon anastomosis and physical therapy.
Basic information】Male, 45 years old
Disease Type】Acute Achilles tendon rupture
Hospital】The First Hospital of Harbin Medical University
Date of consultation】March 2022
Treatment plan】Achilles tendon anastomosis + physical therapy (plaster fixation)
Treatment Period】Discharge from hospital in 2 weeks, regular outpatient follow up
Results】The pain disappeared and the walking returned to normal.
I. Initial consultation
The patient came to the clinic because he could not stand on his tiptoes for one day after playing badminton bouncing. Detailed medical history that the patient is a badminton enthusiast, the ball age has been nearly 10 years, basically every week will be about friends to play a few games. When he landed on the ground after a catch, he suddenly felt as if he had been hit with a stick at the Achilles tendon, accompanied by a thud, after which he could not stand on his feet and could not complete his stirrups and jumps, and had difficulty walking. Finally, the patient had to be assisted by a friend to enter the clinic.
II. Treatment
After careful observation, I found that the tightness of the Achilles tendon had disappeared and was replaced by obvious swelling and bruising, and a depression could be felt at the Achilles tendon when pressure was applied. Subsequent MRI of the Achilles tendon revealed a rupture of the Achilles tendon with a significant hematoma around the rupture area, so the patient was finally diagnosed with an acute Achilles tendon rupture. Due to the high incidence of re-rupture with conservative treatment, surgical repair was preferred. The Achilles tendon could be re-sutured with minimally invasive methods, and post-operative braking with a lower limb cast was supplemented with gradual exercise after 6 weeks of removal of the cast, which could be supplemented with physical therapy to promote the recovery of ankle function.
Treatment effect
The patient was discharged from the hospital 2 weeks after the operation and followed up regularly in the outpatient clinic. 3 weeks after the operation, the cast of the long leg of the lower limb was changed to a cast of the short leg, 6 weeks after the operation, the cast of the lower limb was removed and the walking on the ground was gradually practiced.
IV. Notes
We are glad that the patient was successfully treated and discharged from the hospital. The cast can usually be removed 6 weeks after the surgery of the Achilles tendon rupture, at this time, you can walk slowly at home to let the muscle’s motor ability recover gradually, and you can do jogging training about 4 months after the surgery, and you can resume normal exercise after 6 months. During this period, the family must supervise the patient well, because if the rehabilitation training after Achilles tendon surgery is carried out too late, the muscles will atrophy and the tension of the Achilles tendon will be reduced, but the exercise should be done according to the strength and the intensity of the exercise should be in accordance with their own situation, so as not to cause secondary damage to the Achilles tendon.
Five, personal insight
There are two types of people with a high incidence of Achilles tendon rupture, one is the usual lack of exercise, occasional high intensity sports activities; the other is the sports activities are low-intensity, but long hours of sports activities. Although the Achilles tendon rupture can also be treated non-surgically with plaster immobilization, the incidence of re-rupture of the Achilles tendon is higher with this method than with surgical repair. Therefore, surgical treatment is currently recommended for most Achilles tendon ruptures. After surgery for Achilles tendon repair, the cast is routinely fixed for 6 weeks, during which the length of the cast is gradually adjusted, and after 6 weeks, adaptive exercise is started, which often leads to good results.