Maffulli's 1999 current concepts review in JBJS-A covers the full spectrum of Achilles tendon rupture: anatomy, tendon biomechanics, epidemiology, degenerative etiology, diagnostic tests, and operative vs. nonoperative treatment strategies for both acute and chronic ruptures.
When evaluating a suspected Achilles rupture, use at least two clinical tests (Thompson squeeze, knee-flexion, needle, or sphygmomanometer) to confirm diagnosis — and remember that >20% of ruptures are missed at first presentation.
Treatment choice hinges on patient activity level and risk tolerance: operative repair minimizes re-rupture for athletes, but nonoperative functional bracing is a legitimate option for lower-demand patients willing to accept a higher re-rupture rate in exchange for avoiding wound complications.
Maffulli's 1999 current concepts review in JBJS-A covers the full spectrum of Achilles tendon rupture: anatomy, tendon biomechanics, epidemiology, degenerative etiology, diagnostic tests, and operative vs. nonoperative treatment strategies for both acute and chronic ruptures.
When evaluating a suspected Achilles rupture, use at least two clinical tests (Thompson squeeze, knee-flexion, needle, or sphygmomanometer) to confirm diagnosis — and remember that >20% of ruptures are missed at first presentation.
Treatment choice hinges on patient activity level and risk tolerance: operative repair minimizes re-rupture for athletes, but nonoperative functional bracing is a legitimate option for lower-demand patients willing to accept a higher re-rupture rate in exchange for avoiding wound complications.