Rupture of tearing of the Achilles tendon is a common condition. This typically occurs in the unconditioned individual who sustains the rupture while playing sports, or perhaps from tripping.
There is a vigorous contraction of the muscle and the tendon tears. The patient will often describe the sensation that someone or something has hit the back of the calf muscle. Pain is suddenly present, and although it is possible to walk, it is painful and the leg is weak.
The surgery is performed in order to regain the maximum strength of the Achilles, as well as the normal pushing off strength of the foot. The strength of the muscle depends on establishing the exact correct tension between the muscle and the tendon.
There are old fashioned techniques for repairing the tendon which require very long incisions on the back of the leg almost eight to ten inches long. These are complicated and associated with a very high incidence of infection in the skin after surgery. This problem with the skin and healing, in fact, has in the past led surgeons away from surgical methods of treatment.
Fortunately, there is now a new and really unique method available for operating on and repairing the tendon through a tiny incision. This is a “mini-incision” which is about 2 centimeters in length. This is far more accurate surgery, the tendon repair is easier to recover from, and the complication rate of this type of surgery is lower than the traditional surgery.
Following the tendon repair walking on the foot is permitted in a removable boot. The design of this boot is important, and the movement in the boot will be controlled before the surgery. There were some treatments used many years ago which relied upon a cast applied to the leg, leading to tremendous weakness and atrophy of muscle, which was often permanent.
Instead of a cast, a removable boot is worn, and instead of using crutches, walking is commenced very rapidly after surgery. This treatment has made a huge difference in the recovery process, and therapy and exercises are begun soon after surgery.