Achilles Tendon Rupture, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Achilles tendon rupture is the rupture following inflammation of the Achilles tendon.
Damages to the Achilles tendon are frequent among people of all ages.
Achilles tendon pathologies are rupture and tendonitis.
Other tendon disorders are:
1. Paratenonitis: Featured by paratendon inflammation and thickening, and fibrin adhesions
2. Tendinosis: Featured by intra-substance disarray and degeneration of the tendon
The rupture to the tendon is normally caused by a sudden and immediate plantar-flexion of the ankle or if the foot moves in a direction outside its regular motion.
Other reasons or causes of rupture or Achilles tendon tear are:
1. Excess stress on the tendon brought on in one act or by years of usage,
2. Putting too much effort in a single action after a long rest of the tendon and severe sports.
3. Some antibiotics also weaken the tendons in the body, particularly the Achilles tendon.
4. Patients have injected steroids directly into the Achilles tendon
The rupture is often linked with
Symptoms:
1. Sudden difficulty of movement of the Achilles tendon
2. Swelling of the Achilles tendon involved at the lower leg and heel
3. Local tenderness and gap in the involved Achilles tendon
4. Inability to move the involved foot
Ultrasonography can recognize a ruptured Achilles tendon
Other tests are:
Simmond’s Test
Needle test
Calf Squeeze test
Knee Flexion Test
Heel Raise test
Sphygmomanometer Test
Treatment:
Medical treatment for a patient with an Achilles tendon rupture is rest, control of pain, serial casting, and physiotherapy
rehabilitation to maximize function
Achilles tendon Surgery Types
1. Open Achilles tendon Surgery
The surgeon makes only one incision which is normally about 5 cm long and makes sure that all the torn fibers in the tendon are sutured back together and then left to recover.
Percutaneous Achilles tendon Surgery
In this surgery, a number of small incisions are performed by the surgeon.
These incisions make for quicker healing and also permit the surgeon to see the complete length of the tendon and suture it back together.
The Achilles tendon surgery also is dependent on the type of tear or Achilles tendon rupture of the patient.
The two types of Achilles Tendon Ruptures are:
1. Chronic Tear
A tear is regarded chronic if the muscle is shortened.
It has been weeks or months since the rupture and the patient has still not had it surgically repaired.
In this patient, the most important factors are the distance of separation present and the amount of the gap present between the tendons.
Acute Tear
An Achilles tendon tear is acute if the patient informs a doctor within a couple of weeks of the injury that ruptured his Achilles tendon.
In most acute tear cases, the separation is pretty negligible and the ends of the tendon can be sutured back together.
With the enlargement in the gap, more extreme measures are to be taken.
This can range any thing between using a simple strip of the present injured tendon to using a dissimilar tendon for tendon transfer or discussing with a tissue bank about an Achilles tendon graft.
Tendon Transfers
Tendon transfers are not done widely, as it is performed only when the gap present is very wide.
The tendon used during the transfer is normally the next strongest tendon present in the leg.
This is the flexor hallucis longus, the muscle available next to the big toe.
An Achilles tendon surgery provides the best results only if the procedure is done at the earliest.
TABLE OF CONTENT
Introduction
Chapter 1 Achilles Tendon Rupture
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Achilles Tendonitis
Chapter 8 Plantar Fasciitis
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Achilles Tendon Rupture, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Achilles Tendon
Rupture,
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2017 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Achilles Tendon Rupture, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What You Need to Treat Achilles Tendon Rupture)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Conditions
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from the reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Achilles Tendon Rupture
What is Achillles tendon rupture?
Achilles tendon rupture is the rupture following inflammation of the Achilles tendon.
Damages to the Achilles tendon are frequent among people of all ages.
Achilles tendon pathologies are rupture and tendonitis.
Many doctors now believe that tendonitis is a misleading term that should no longer be used, because signs of true inflammation are almost never found on histological examination.
Instead, the following histopathologically determined nomenclature has developed:
1. Paratenonitis: Featured by paratendon inflammation and thickening, and fibrin adhesions
2. Tendinosis: Featured by intra-substance disarray and degeneration of the tendon
The rupture to the tendon is normally caused by a sudden and immediate plantar-flexion of the ankle or if the foot moves in a direction outside its regular motion.
Other reasons or causes of rupture or Achilles tendon tear are:
1. Excess stress on the tendon brought on in one act or by years of usage,
2. Putting too much effort in a single action after a long rest of the tendon and severe sports.
Some antibiotics also weaken the tendons in the body, particularly the Achilles tendon.
What are the causes of Achilles tendon rupture?
Causes:
The cause of Achilles tendon rupture is from:
1. Damage or trauma to the Achilles tendon-minor tears in the tendon of these muscles is always present in injury
2. Repetitive over usage of Achilles tendon particularly in a runner resulting in a rupture
People who are more vulnerable to rupture of the Achilles tendon are:-
1. Professional Athletes
2. People who have had problems with the Achilles tendon or the muscles connecting that tendon before.
3. Old people
4. Children or adults who play extreme sports where the body takes a toll, ex: football and rugby
5. People who have previously injected or are still injecting steroids directly into the Achilles tendon.
The rupture is often linked with intense Achilles tendon pain and swelling.
It can occur from a horrific sports injury or by one small accident when walking.
What are the symptoms and signs of Achilles Tendon Rupture?
Onset is normally slow unless caused by injury
Patients with an Achilles tendon rupture caused by injury often are present with complaints of a sudden snap in the lower calf linked with acute, severe pain.
The patient complains feeling like he or she has been hit, jolted, or cut in the back of the leg, which may lead to an inability to move further.
Symptoms:
1. Sudden difficulty of movement of the Achilles tendon
2. Swelling of the Achilles tendon involved at the lower leg and heel
3. Stiffness of the Achilles tendon - inability to move
4. Pain often moves into the foot
Signs:
1. Swelling of the involved Achilles tendon
2. Local tenderness and gap in the involved Achilles tendon
3. Dry crepitus on movement of the Achilles tendon is present
4. X-rays are normally ordinary even though an ultrasound may show minor tears in the tendon.
5. A patient with Achilles tendon rupture will be unable to stand on his or her toes on the affected side.
Tendinosis
Tendinosis is often free from pain.
Normally, the only sign of the disorder may be a palpable intra-tendinous nodule that goes with the tendon as the ankle is put through its range of motion (ROM).
Paratenonitis
Patients with paratenonitis normally show symptoms of warmth, swelling, and diffuse tenderness sited 2-6 cm proximal to the tendon's insertion.
Paratenonitis with tendinosis
This is diagnosed in patients with action-linked pain, and swelling of the tendon sheath and tendon nodularity.
How is Achilles tendon rupture diagnosis made?
Diagnosis:
Laboratory studies normally are not essential in assessing and diagnosing an Achilles tendon rupture or injury, even though assessment may help to exclude some of the other possibilities in the differential diagnosis.
Achilles tendon Rupture Test – The Different Tests
An Achilles tendon rupture test is normally done in order to diagnose any injury done to the tendon.
Once the damage is recognized, the extent to which the tendon has been injured can be confirmed.
An Achilles tendon rupture test like an MRI can assist in recognizing the extent of injury caused
By testing for injury and the extent of the injury, doctors can prescribe which method of Achilles tendonitis treatment to be used.
Simmond’s Test
This test is also termed the Thompson test or the Simmond’s-Thompson test.
In the Simmond’s test, the patient is asked to lie face down on a bed with his legs hanging from the bed surface from the knee downwards.
The doctor then compresses the calf and massages it gently.
If this is done to