Background: There has been considerable debate about the best
treatment for acute rupture of the Achilles tendon. At our institution, a
well-documented and structured program of nonoperative management of Achilles
tendon rupture with use of casts and a removable orthosis was developed.
Methods: We assessed the results in 140 consecutive patients with a
complete rupture of the Achilles tendon who had been treated with our
nonoperative regimen at our center between 1992 and 1998. Patients were
evaluated on the basis of the subjective results and clinically with
Results: Overall, 56% of our patients had an excellent result; 30%,
good; 12%, fair; and 2%, poor. The overall complication rate was 8%, with
three complete and five partial tendon reruptures, two deep vein thromboses,
and one temporary dropfoot.
Conclusions: The results of our nonoperative orthotic treatment were
better overall than published results of operative repair of acute Achilles
tendon rupture. Our patients were quite satisfied with their treatment.
Level of Evidence: Therapeutic study, Level IV (case
series [no, or historical, control group]). See Instructions to Authors for a
complete description of levels of evidence.