Achilles tendon ruptures are injuries that are becoming more common as the participation of recreational activities continue to increase. Fortunately, most acute ruptures are identified and treated within the first month of the injury, whether by immobilization or by primary surgical repair. Ruptures are sometimes missed by physicians or ignored by patients and the consequences of the so-called neglected Achilles rupture can be devastating. Surgical repair of neglected Achilles ruptures is less controversial than that of acute ruptures; however, selection of the most appropriate procedure often proves difficult. There have been a number of surgical approaches described to treat the neglected rupture. We present a review of the surgical approaches described in the literature as well as an illustration of our preferred methods.
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