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Achilles tendon tears, the
bane of many middle-aged "weekend warriors," may heal as effectively
with a supportive splint and exercises as with surgery, according to Dr.
Alexandra Kirkley, associate professor of surgery at the University of
Western Ontario, London, Ontario, Canada.
Although surgery is the method
typically used for these common sports injuries, the nonsurgical method
may be as effective, with fewer risks.
Rupture of the Achilles tendon
is a surprisingly common injury, occurring most often in middle-aged people
who are trying to stay fit and participate in recreational activities.
Some of the sports where people are at risk include basketball, tennis
and squash, as well as any other sports that involve jumping and starts
and stops.
In this small trial the researchers
compared treatment outcomes in 24 people who had torn their Achilles tendon.
Among these people, 12 were treated with a splint, and with rehabilitation
exercises that emphasized motion and resistance. The other 12 were treated
with conventional Achilles repair surgery.
The basic scientific rationale
for the splint with exercises is that, if you have a healing tendon and
apply motion and resistance, the tendon heals much more completely. The
splint protects the tendon, but it allows for motion and load-bearing
exercises.
The investigators assessed
the outcomes with a questionnaire and with evaluations that included range
of motion, walking, and hopping on one foot. According to these measurements,
the two groups were very similar at the end of the study.
It's exciting to see that you
can get the same result without having to subject someone to the risk
of surgery. It looks like motion and stress are important to recovery.
Although surgical repair is the conventional method for treating Achilles
tendon tears, some patients may have health risks that make surgery unwise,
such as diabetics and smokers. Other patients may be reluctant to undergo
surgery.
This study shows that it's
safe to treat people for an Achilles tendon rupture without surgery. "For
the patient who wants to avoid surgery, or for the patient who has risk
factors, there is a nonsurgical option that will give them an excellent
result."
28th
Annual Meeting Of The American Orthopaedic Society For Sports Medicine
July 3, 2002 New York, New York
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