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Abstract: The Achilles tendon is a thick and taut tendon between the heel and the calf, about 15 cm long, and the location of the Achilles tendon is normally visible as a skin bulge. In this article, the patient had pain at the Achilles tendon after basketball and had difficulty walking. After examination, the patient was diagnosed with an acute Achilles tendon tear, and after Achilles tendon repair surgery + physical therapy, the patient’s pain disappeared and he resumed walking normally.
Basic information】Male, 31 years old
Disease Type】Acute Achilles Tendon Tear
Hospital】The First Hospital of Harbin Medical University
Date of consultation】March 2022
Treatment plan】Achilles tendon repair surgery + physical therapy (plaster fixation)
Treatment Period】2 weeks in hospital, regular outpatient follow up
Results】The pain disappeared and the walking returned to normal.
I. Initial consultation
The patient was 175cm tall, weighed 90kg, and had a fat body type. After a basketball game, he had pain at the Achilles tendon and had difficulty walking, and after detailed questioning, he learned that the patient seldom exercised, but in recent days, he decided to start exercising because he was not satisfied with his body shape. A day ago, during a basketball game when he jumped up and landed, he suddenly felt a tearing sensation in his Achilles tendon, and immediately afterwards his ankle became soft, and he could not walk or tiptoe, and was sent to the emergency room by 120 emergency vehicle.
II. Treatment
After listening to the patient’s description, the initial judgment was that it was a problem with the Achilles tendon. Through careful observation, it was easy to find that the normal tightness of the patient’s Achilles tendon had disappeared, accompanied by swelling and petechiae formation, and the patient’s ankle flexion strength was obviously insufficient. The MRI of the Achilles tendon showed that the Achilles tendon had a little bit of connection left and the main body was broken, which was finally diagnosed as an acute Achilles tendon tear. Since the Achilles tendon is mainly tendinous tissue with poor local blood circulation and poor healing ability, this condition is not suitable for conservative treatment and surgical repair of the Achilles tendon is preferred. After the repair of the Achilles tendon, the lower limb needs to be fixed in a cast for about 6 weeks and gradually functional exercises.
Third, the treatment effect
The patient’s stitches were removed 2 weeks after surgery, and he was discharged from the hospital successfully. In general, after 2-3 months after the surgery, the heel can fall to the ground and the ankle joint can move normally.
IV. Precautions
We are happy for the patient that the surgery was successful and he was discharged from the hospital. However, after the Achilles tendon repair surgery, it does not mean that everything is fine. It still needs about 6 weeks of plaster fixation, which should be long, including the ankle, calf and knee, and extending upward to the mid-thigh. to the foot and upward no more than the knee joint, and the cast can be removed after a total of 6 weeks. In the early stage, the ankle joint extension and flexion exercises can be performed on tiptoe, and the patient can gradually return to normal walking on the ground. During this period, family members should accompany the patient and encourage the patient to give him/her confidence.
V. Personal insight
For this patient, there is nothing wrong with exercise and fitness, but it must be gradual. When you are heavier, try to choose relatively mild exercise methods such as swimming and elliptical machine, and you must warm up well before exercise and choose a good sports field.