To compare the functional outcome of role of conservative versus operative management in acute tendoachilles tendonrupture

Abstract

Introduction: The Achilles tendon, the strongest and largest tendon in the body, is the most commonly ruptured tendon in the lower limb. Ruptures typically result from forced eccentric loading on a plantar-flexed foot. This injury can significantly impair ambulation and activity, impacting both athletes and non-athletes. The two main treatment strategies for Achilles tendon rupture are surgical repair and conservative management, yet the optimal approach remains debated. Aim and Objective: This study aims to compare the outcomes of 20 patients with Achilles tendon ruptures treated either conservatively or operatively, focusing on re-rupture rates, complication rates, and functional outcomes based on the Achilles Tendon Total Rupture Score (ATRS) up to one year post-treatment. Materials and Methods: Patients were divided into two groups: Group A, which received conservative management, and Group B, which underwent surgical repair. Each group comprised 10 patients aged 30-50 years. Follow-up assessments were conducted at 6 weeks, 6 months, and 1 year, with clinical evaluations and outcomes graded according to the ATRS. Results: Significant differences were noted between the two groups in terms of complication rates, including tendon adhesion, sural nerve injury, and superficial infections. At the one-year follow-up, the mean ATRS scores were 86 for Group A and 88 for Group B. The re-rupture rate was higher in Group A (6.2%) compared to Group B. Conclusion: Surgical treatment for Achilles tendon ruptures reduces the risk of re-rupture compared to nonoperative treatment but is associated with a higher incidence of other complications. Open surgical repair remains a preferred technique for managing acute Achilles tendon ruptures. Effective immobilization followed by physiotherapy supports early recovery and enables independent full weight-bearing walking. Ultimately, the choice between operative and nonoperative management should be tailored to individual patient factors and involve shared decision-making.