010 020 5050 | 80 Van Bergen St,
Brackenhurst, Alberton
011 883 1719 | Rivonia Rd, Hill Rd,
Sandton, 2057
When the Achilles tendon rupture is not diagnosed early on, the ends of the tendon begin to separate (retract). Walking and pushing off with the foot become increasingly difficult.
There are however other muscles in the leg which try to compensate for the loss of the Achilles and the leg muscle (the gastrocnemius muscle), but these are never sufficient to maintain the power and strength of the leg.
Due to the extra workload on the other muscles of the leg which try to compensate for the weakness, the toes begin to curl and may become permanently deformed.
Treatment of a chronic rupture of the Achilles tendon can be initiated with the use of a brace, but ultimately, surgery should be performed and is highly recommended for younger active individuals.
While a brace never restores a full function of the leg and there is always weakness, it does permit some increased strength in push off since a spring is attached to the brace which fits inside the shoe.
Surgical treatment is however ideal and should be performed as soon as possible after the diagnosis is made to maximize the return of strength before the tendon retracts too far.
The type of surgery performed depends on the size of the gap between the tendon ends and the extent of the separation that is present.
The tendon transfer uses the second strongest muscle in the leg after the gastrocnemius, which is the muscle to the big toe (the flexor hallucis longus).
The goal of surgery is to return you to full healing and strength of the tendon in as short a time as possible. You will need to use crutches for 10 days after surgery, and then as soon as the swelling has subsided, you will begin walking on the cast.
When converted to the range of motion Moon boot there is hinge on the boot which will allow the foot to go downwards (plantarflexion) but will limit the ability of the foot to go in an upward direction (dorsiflexion).
Walking and exercise are very important after the surgery and a careful physical therapy program which I have developed in conjunction with physiotherapist and Biokineticist’s will be necessary.
You may experience a variety of sensations whilst in the cast consisting of sharp shooting, dull aches, electric shocks, throbbing, sensation of itching and these are all normal and you should not panic.
You will also be placed on DVT prophylaxis as there is a risk of blood clots shooting to the lungs with this procedure for a period of 6 weeks.
Strength of the leg after the reconstruction is good, but unfortunately, never normal after a chronic rupture reconstruction.
You will be able to push off with one leg, play tennis and exercise, but it may be difficult to run. You will need to work hard in physical therapy to regain strength in the leg.
Given the extensive nature of this type of surgery and the location of the incision, wound complications do occur and these are usually treated with alternative dressings and sometimes a low pressure vacuum dressing with the aid of a dressing Sister and may alter the specific post-operative recovery schedule discussed below.
CAST REMOVED
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