Achillessehnenrupturen

Abstract

In the current literature the incidence of ruptures of the Achilles tendon is reported to be 12-18/100,000. The Achilles tendon transfers the force of the m. triceps surae to the ankle joints, conducting plantar flexion and supination. Therefore injuries to this tendon usually involve a severe loss of function of the lower limb. The main reasons for this type of injury are usually degenerative changes of the tendon promoted by particular vascular supply and fibre orientation. Acute Achilles tendon ruptures are diagnosed clinically. State-of-the-art imaging is ultrasound using a 7.5 MHz device. The therapy strategy is decided individually based on the constitution of the patient (physical demands, activity level, patient's age, the age of the injury and comorbidities). Looking at the literature, conservative treatment involves higher rerupture rates. Primary surgical treatment, in a minimally invasive, percutaneous manner, shows advantages in wound healing, while yielding similar re-rupture rates compared to an open procedure. For treatment of chronic tears and re-ruptures, open procedures with autologous tendon augmentation are possible. Concerning expert assessment of Achilles tendon injuries the course of the injury takes centre stage whether or not the force causing the injury was within the physiological range. © Springer-Verlag 2010.