The optimal treatment for acute rupture of the Achilles tendon still
remains controversial. This well-done study by Möller et
al. had a large sample size and several methods of evaluation including
clinical examination, visual analog scores, functional performance
testing, and comparison of time lost from work. The duration of
immobilization was substantially different between the 2 groups.
In the nonsurgical treatment group, the ankle was immobilized in
a cast in equinus for 4 weeks and then in a cast in a neutral position
for another 4 weeks. In the surgical treatment group, the cast was worn
for only 12 days postoperatively, after which a functional brace
was worn with full weight-bearing and range-of-motion exercises
from weeks 3 to 8. In my view, this important difference in the
treatment protocol could have influenced the outcome.