J Korean Orthop Assoc.  1978 Jun;13(2):171-178. 10.4055/jkoa.1978.13.2.171.

A Clinical Study of Neglected Rupture of the Achilles Tendon

• Kang JD
• Kim DG
• Kim CU

• KMID: 2460379
• DOI: http://doi.org/10.4055/jkoa.1978.13.2.171

Abstract

Since rupture of the Achilles tendon was first reported by Pare in 1575, various caues and diagnostic and therapeutic methods have been described by many workers. Almost all these workers agree that with early diagnosis and early treatment the prognosis is good. But the incidence of misdiagnosis by the physician as well as the patient's own neglect of his condition is disconcertedly high one. Nevertheless, negiected rupture of the Achilles tendon may lead to good results by proper selection of tbe operative method. In this report 16 cases of neglected ruptures of the Achilles tendon, in which treatment had been delayed more than 3 weeks were reviewed. A follow-up study of more than 6 months was made on 14 of these cases treated during the 5 year period from February 1973 to August 1977. The results are summarized as follows: 1. The causes responsible for the neglected ruptures were misdiagnosis by the physician in 62.5% and the patient's own neglect of his condition in 25% of the cases. The patient, in many cases, failed to seek medical treatment because of the rapid disappearance of pain, the absence of an open wound, ability of mild ankle plantar flexion, and the ability to walk. 2. Neglected rupture of the Achilles tendon occured most commonly in man of 4th decade. 3. Left side injuries were more common than right side injuries with a ratio of 9:7. 4. Ruptures by indirect injury were more common than by direct injury with a ratio of 9:7, and were most common during recreation and sports activities. 5. The most frequent site of rupture was 2 to 6 cm above the insertion of the tendon with 81% of the cases. 6. The end-to-end suture with pull-out wire method and Lindholm's operative method gave good (Excellent or Satisfactory) results in neglected rupture of the tendon as well. 7. Even in cases of neglected Achilles tendon rupture, normal function can be regained in approximately 6 months post-operatively if proper method of treatment is selected.

MeSH Terms

Achilles Tendon*
Ankle
Clinical Study*
Diagnostic Errors
Early Diagnosis
Follow-Up Studies
Humans
Incidence
Methods
Prognosis
Recreation
Rupture*
Sports
Sutures
Tendons
Wounds and Injuries