Which is the best treatment option for Achilles tendon rupture: surgery or conservative management such as casting and physiotherapy ?
Opinions have always differed among orthopedic surgeons as to whether surgical or conservative management is best for Achilles tendon rupture. Surgical treatment usually involves simply suturing the two ends of the tendon back together. This can be done under general anesthetic, or simply local freezing. Following the surgery a cast is usually required, this prevents the newly repaired area from being stressed before healing has taken place. When conservative management is employed, it usually involves the same type of cast. This is often placed with the ankle in plantar flexion (like standing on your toes) to bring the two ends of the tendon close together and allow them to re-heal back to one another. Plan on wearing the cast for about 6-8 weeks. Following the casting, with or without surgery, a careful period of physiotherapy and progressive re-introduction to sports is planned in order to minimize re-tearing of the tendon A recent large study of 111 patients concluded that surgical
