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Surgery May Not Be Needed for Ruptured Achilles Tendon
Date:12/29/2012

By Alan Mozes
HealthDay Reporter

FRIDAY, Dec. 28 (HealthDay News) -- In the long run, patients who rupture their Achilles tendon fare equally well following nonsurgical treatment as they do with surgery, a new Canadian research review shows.

The catch: Nonsurgical patients can only expect to see results on par with surgery patients if they simultaneously engage in so-called functional rehabilitation, a bracing process that offers patients the opportunity to quickly engage in range-of-motion exercises to promote tendon healing.

And even so, nonsurgical patients will experience a slower speed of recovery than surgery patients.

"[But] if you rupture your Achilles you need to consider nonoperative treatment, because it's safer than surgical treatment," said study co-author Dr. Mark Glazebrook. "What this means is that if you have nonoperative treatment with functional rehabilitation you will have an outcome just as good as surgery and you almost eliminate the absolute risk for surgical complications."

Glazebrook, an assistant professor of surgery in the division of orthopedics at Dalhousie University Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia, and colleagues discuss their findings in the Dec. 5 issue of the Journal of Bone and Joint Surgery.

The Achilles tendon -- located at the back of the leg, between the heel and calf -- is the most commonly ruptured tendon, the study team pointed out.

Nonsurgical treatment options typically involve the use of a cast, a cast-boot or a splint, sometimes accompanied by physical therapy or functional rehabilitation bracing. Such bracing is a relatively recent innovation that enables patients to begin monitored range-of-motion exercising very shortly after the initial injury.

Nevertheless, in the United States, surgery has been the more favored treatment route, in large measure due to the widespread belief that the r
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