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 your 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 medicine. You may have taken steroids to help your muscles grow or to decrease inflammation (redness and swelling).
  
  
• Your Achilles tendon will rupture if there is too much pressure put on it. This may happen during sports or if you fall down stairs, get kicked, or weigh a lot. 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, cast, or brace to fix your Achilles tendon. Having your Achilles tendon treated will help decrease your pain and help you to walk normally again. You may be able to return to work sooner and more easily complete your normal daily activities.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• If you are treated with a cast or brace, then your Achilles tendon may rupture again. You may get an infection or a tear in your skin. You may also get an infection if you have surgery. You may develop keloids (big scars), skin problems, or numbness where you had your 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 also cause a heart attack or a stroke. You may die from these conditions.
  
  
• With or without treatment, your Achilles tendon may rupture again. Without treatment, you may always have trouble walking or moving your foot. One or more of your bones may break. The nerves in your legs may be injured. This may cause a numbness, tingling, or burning feeling in your legs. You may get a blood clot. If the blood clot causes a PE, heart attack, or stroke, then you may die. Ask your caregiver for more information about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Medicine:

• Blood thinners: This medicine helps stop clots from forming in your blood. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it easier for you to bleed or bruise. If you shave, use an electric shaver. Use a soft toothbrush to help keep your gums from bleeding.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.

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

• X-rays: Your caregiver may take x-rays of your ankle and foot. This may help your caregiver see if there is swelling in your tendons or muscles. He may also see if you have broken any bones. An x-ray may also show changes in the shape of the tendon and surrounding spaces.
  
  
• Magnetic resonance imaging: This is also called an MRI. Your caregiver will use this test to see how much tendon damage you have. This test may also show if you have swelling and bleeding around the torn tendon. During the MRI, pictures are taken of your Achilles tendon and the muscles and bones around it. You will need to lie still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This 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 options: There are both surgery and non-surgery treatments for your Achilles tendon rupture. 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.

• Non-surgery choices:
  
  
  • Casts: Your caregiver may put a cast on your leg. This cast may stay on your leg for two months or more. This cast may go up to your knee or may extend past your knee. Your foot will be put into a position 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 OK.
    
    
  • Leg braces: You may be asked to wear a leg brace or splint to prevent you from moving your foot. These braces allow you to move your leg and walk, but not until your caregiver says it is OK. Leg braces may also help you from getting another injury in your leg, ankle, or foot.
    
    
  • Heel lifts: Heel lifts are special wedges that are inserted into your shoes or cast. Heel lifts help keep your foot in the best position for healing.
  
  
• Surgery choices:
  
  
  • 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 are called grafts and are used to patch up 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 up your Achilles tendon. Your caregiver will then close the small cuts with stitches and put your leg in a cast.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.

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