Mr. Lu called to ask: I strained my right heel playing badminton and the doctor diagnosed it as a ruptured Achilles tendon and recommended that I be hospitalized for surgery. I didn’t agree to surgery at that time and just had it fixed in a cast. A week has passed and the injury has not improved significantly, do I have to undergo surgery? Answer: Achilles tendon rupture is a common sports injury. Generally, doctors will recommend surgery for Achilles tendon ruptures because conservative treatment focuses on keeping the ankle in extreme plantarflexion with a cast for 4 weeks to allow the ruptured end of the Achilles tendon to contact and heal on its own. However, conservative treatment has a high incidence of non-healing and re-rupture of the Achilles tendon. In contrast, surgical treatment can ensure the quality of repair of the Achilles tendon and reduce the incidence of re-rupture. Surgical treatment mainly involves incision and suturing of both sides of the Achilles tendon, fixing the Achilles tendon severed ends with sutures to achieve full and firm contact, and then fixing the Achilles tendon severed ends with a cast for 4 to 6 weeks to achieve full healing. The advantage of surgical treatment is the exact efficacy, while the disadvantage is the incisional complication rate of 10%-20%. Postoperative complications include non-healing or delayed wound healing, local infection, skin necrosis, and in some patients, even infection and necrosis of the Achilles tendon. Considering the high chance of non-healing and re-rupture of the Achilles tendon after conservative treatment, physicians generally recommend that patients undergo surgical suturing as soon as possible, although there is a possibility of surgical complications with surgical treatment. In recent years, minimally invasive suturing techniques have been developed in the medical community to reduce the complications of open surgery. However, this technique is only available for patients with fresh Achilles tendon ruptures. In general, the minimally invasive suture technique can be used in most patients with an Achilles tendon rupture within 3 weeks of the injury.