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Partial Achilles Tendon Rupture - A Neglected Entity : A Narrative Literature Review on Diagnostics and Treatment Options
Matthias Gatz (Författare), Christoph Spang (Författare), Håkan Alfredson (Författare)
URI http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-177183, URN urn:nbn:se:umu:diva-177183, DOI 10.3390/jcm9103380
Umeå universitet Medicinska fakulteten (Utgivare), Umeå universitet Medicinska fakulteten (Utgivare)
utgivning
MDPI, 2020är del av
Journal of Clinical Medicine · ISSN 2077-03839:10
Bidrag, Onlineresurs
ämne
Medical and Health Sciences, Health Sciences, Sport and Fitness Sciences, Medicin och hälsovetenskap, Hälsovetenskap, Idrottsvetenskap, partial rupture, partial tear, achilles, tendinopathySammanfattning
Partial ruptures in the Achilles tendon are rather uncommon and are often misinterpreted as aggravated Achilles tendinopathy, and not always considered as a differential diagnosis. The aim of this literature review was to characterize typical symptoms, to provide an overview of available diagnosis and treatment options, and to give reference points for future research. There were few studies and sparse knowledge of scientific value, making it difficult to give evidence-based recommendations. Based on the few studies and the authors' clinical experience, a diagnosis should be based on a patient's history with a typical sharp onset of pain and inability to fully load the tendon. Previous intratendinous cortisone injections might be present. Clinical findings are a localized tender region in the tendon and often weakness during heel raises. Ultrasound and Doppler examinations show a region with an irregular and bulging superficial tendon line, often together with localized high blood flow. Magnetic resonance Imaging (MRI) shows a hyperintense signal in the tendon on T1 and T2-weighted sequences. First-line therapy should be a conservative approach using a 2 cm heel lift for the first 6 weeks and avoiding tendon stretching (for 12 weeks). This is followed by a reduced heel lift of 1 cm and progressive tendon loading at weeks 7-12. After 12 weeks, the heel lift can be removed if pain-free, and the patient can gradually start eccentric exercises lowering the heel below floor level and gradually returning to previous sport level. If conservative management has a poor effect, surgical exploration and the excision of the partial rupture and suturing is required. Augmentation procedures or anchor applications might be useful for partial ruptures in the Achilles insertion, but this depends on the size and exact location. After surgery, the 12 to 14-week rehabilitation program used in conservative management can be recommended before the patient's return to full tendon loading activities.
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Medverkan och funktion
Matthias Gatz (Författare), Christoph Spang (Författare), Håkan Alfredson (Författare)Medverkan och funktion
Umeå universitet Medicinska fakulteten (Utgivare), Umeå universitet Medicinska fakulteten (Utgivare)Identifikator
URI http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-177183, URN urn:nbn:se:umu:diva-177183, DOI 10.3390/jcm9103380har titel
Partial Achilles Tendon Rupture - A Neglected Entity : A Narrative Literature Review on Diagnostics and Treatment Optionsär del av
Journal of Clinical Medicine · ISSN 2077-0383del
9:10utgivning
MDPI, 2020tillhörande media
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-177183http://dx.doi.org/10.3390/jcm9103380http://umu.diva-portal.org/smash/get/diva2:1505581/FULLTEXT01Relaterad beskrivning eller innehåll
Värdpublikationanmärkning
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tillhörande media
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-177183http://dx.doi.org/10.3390/jcm9103380http://umu.diva-portal.org/smash/get/diva2:1505581/FULLTEXT01Villkor för användning och åtkomst
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t67zzqllrw7bt7jmResursens ID / Permalänk: https://libris.kb.se/t67zzqllrw7bt7jm#it
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