Achilles Tendon Rupture

WHAT YOU SHOULD KNOW:

• Your Achilles tendon has ruptured if it gets a tear in it. A tendon is body tissue that connects your muscles to your bones. Your Achilles tendon connects the calf muscle in your lower leg to your heel bone. It acts like a spring by taking the force (pressure) from your body when it moves. It also allows you to push your foot toward the ground, such as when walking, running, or jumping. Medical conditions that affect your joints, bones, and muscles may increase your risk of having a rupture. Other risks include taking certain antibiotic (germ fighting) or steroid medicines.
  
  
• Your Achilles tendon may rupture if too much pressure is put on it. This may happen while playing sports or if you fall down stairs, get kicked, or weigh more than you should. You may feel a sudden pop that is followed by sharp pain on the back of your leg. You may find it hard to walk, go up and down stairs, or put weight on your leg. Your caregiver will look at your legs and ask you questions about your symptoms. Your caregiver may tell you that you need surgery, a cast, or a brace to fix your Achilles tendon. Having your rupture treated may help increase the strength in your leg muscles. Treatment may help decrease your pain. You may be able to return to work sooner and do your normal daily activities more easily after treatment.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• With or without treatment, your Achilles tendon may rupture again. If your Achilles tendon ruptures, you may get an infection or a tear in your skin. If you have surgery, you may develop keloids (big scars), skin problems, or numbness in your ankle or foot. After surgery, a blood clot may form in the veins of your leg and may cause a pulmonary embolism (PE). A PE is when a blood clot blocks an artery (blood vessel) in your lungs. A blood clot may cause a heart attack or a stroke, and you may die.
  
  
• Without treatment, you may always have trouble walking or moving your foot. One or more of your bones may break. The nerves in your leg may be injured. This may cause a numbness, tingling, or burning feeling in your leg. If the blood clot causes a PE, heart attack, or stroke, you may die. Ask your caregiver for more information about your ruptured Achilles tendon, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicine:

• Blood thinners: This medicine helps prevent clots from forming in the blood. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

Your caregiver may use imaging tests to help plan your surgery.

• X-ray: Your caregiver may take x-ray pictures of your ankle and foot. The pictures may help your caregiver see if there is swelling in your tendons or muscles, of if you have broken any bones. An x-ray also may show changes in the shape of the tendon and surrounding spaces.
  
  
• Magnetic resonance imaging: This is also called an MRI. During an MRI, pictures are taken of your Achilles tendon and the muscles and bones around it. Your caregiver will use this image to see how much tendon damage you have. This image also may show if you have swelling and bleeding around the torn tendon. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. Metal objects can cause serious injury.
  
  
• Ultrasound: An ultrasound is a simple test that looks at the inside of your body. Sound waves are used to show pictures of your Achilles tendon on a TV-like screen. This may help your caregiver see if your Achilles tendon is torn.

Treatment:

Your treatment will depend on your health, age, level of activity, and type of rupture. You and your caregiver will decide on the treatment that is best for you.

• Casts: Your caregiver may put a cast on your leg. This cast may stay on your leg for two months or more. The cast may go up to your knee or may extend past your knee. Your foot will be positioned in the cast with your toes pointing slightly downwards. Your caregiver will change your cast and your foot position several times during the time you are healing. You will not be able to move your foot and ankle until your Achilles tendon heals. Do not move or put weight on your foot until your caregiver tells you it is okay.
  
  
• Leg braces: You may be asked to wear a leg brace or splint to prevent you from moving your foot. These braces will allow you to move your leg and walk when your caregiver says it is okay. Leg braces also may help prevent you from getting another injury in your leg, ankle, or foot.
  
  
• Heel lifts: Heel lifts are special wedges that are put into your shoe or cast. Heel lifts help keep your foot in the best position for healing.
  
  
• Surgery:
  
  
  • Open surgery: Your caregiver will make a cut on the back of your leg next to your ruptured Achilles tendon. The edges of your Achilles tendon will be sewn back together with special thread (sutures). If your tear is very wide, your caregiver may use pieces of another tendon or man-made material. These pieces are called grafts and are used to patch the tear in your Achilles tendon. Your caregiver will then close the cut with stitches and put your leg in a cast.
    
    
  • Percutaneous surgery: Your caregiver will make several small cuts on the skin near your ruptured Achilles tendon. Your caregiver will then use special tools to sew your Achilles tendon. Your caregiver will then close the small cuts with stitches and put your leg in a cast.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Achilles Tendon Rupture (Inpatient Care)