Thompson, J Trauma 1962 - Spontaneous Rupture of Tendon of Achilles: A New Clinical Diagnostic Test

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Spontaneous Rupture of Tendon of Achilles: A New Clinical Diagnostic Test

Thompson, Doherty·J Trauma·1962·239 citations·Case series

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Thompson and Doherty tested whether squeezing the calf can identify complete Achilles tendon rupture at the bedside. Case series of 47 operatively explored Achilles ruptures with supporting cadaveric experiments; the calf squeeze test was performed clinically in 19 patients and compared with operative findings.

Key Findings

Calf squeeze test positive in 19 of 19 clinically tested ruptures.
Operative findings: 46 of 47 ruptures were complete.
Initial misdiagnosis as sprain or partial tear: 22 of 47. 21 of these 22 were complete ruptures at surgery.
Radiographs failed to show the rupture or were misinterpreted in 11 of 27 cases.
Significance: The Thompson test gave clinicians a simple bedside sign of complete Achilles rupture in a condition frequently missed as a sprain on initial assessment and on radiographs.

Board PearlA positive Thompson test is absence of plantar flexion when the calf is squeezed, indicating complete Achilles tendon rupture.

Spontaneous Rupture of Tendon of Achilles: A New Clinical Diagnostic Test.

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Spontaneous Rupture of Tendon of Achilles: A New Clinical Diagnostic Test

Thompson, Doherty·J Trauma·1962·239 citations·Case series

|

Thompson and Doherty tested whether squeezing the calf can identify complete Achilles tendon rupture at the bedside. Case series of 47 operatively explored Achilles ruptures with supporting cadaveric experiments; the calf squeeze test was performed clinically in 19 patients and compared with operative findings.

Key Findings

Calf squeeze test positive in 19 of 19 clinically tested ruptures.
Operative findings: 46 of 47 ruptures were complete.
Initial misdiagnosis as sprain or partial tear: 22 of 47. 21 of these 22 were complete ruptures at surgery.
Radiographs failed to show the rupture or were misinterpreted in 11 of 27 cases.
Significance: The Thompson test gave clinicians a simple bedside sign of complete Achilles rupture in a condition frequently missed as a sprain on initial assessment and on radiographs.

Board PearlA positive Thompson test is absence of plantar flexion when the calf is squeezed, indicating complete Achilles tendon rupture.

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