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Achilles tendon total rupture

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Molesy Jul 2015 12:08pm, 27 Jul 2015 2,217 posts	0 Molesy Anyone (else) had one? Following problems lasting a couple of years with Insertional Achilles Tendinopathy and Retro-calcaneal Bursitis leading to a couple of steroid injections to the bursa my Achilles has now detached itself completely from my heel after a running jump into the swimming pool whilst on holiday in France. I was carted off to hospital and they've re-attached the tendon with bone anchors. So I'm wondering what happens now? According to the surgeon here I'm supposed to keep the existing cast (pointed toes) on for three weeks and then have it replaced with one where the ankle is at 90 degrees. There seem to be conflicting views on the recovery process online with everything from starting with pointed toes to months of gradually reducing the ankle angle to removing the cast at two weeks and mobilising the ankle/Achilles as quickly as possible. I just wondered if anyone knew what the current UK best practice was.
lammo Jul 2015 12:15pm, 27 Jul 2015 6,146 posts	0 lammo No idea, but i hope you're OK. Was it painful when it went? I would assume that gradual change was a more sensible option, but also that medical teams now want people to mobilise as much as possible as soon as possible. Good luck. PS: Check out the "snip" thread.
Molesy Jul 2015 12:43pm, 27 Jul 2015 2,219 posts	0 Molesy Surprisingly not, there was a dull pain as I took off like I'd been kicked in the ankle but that was all. I couldn't walk on and any attempt to stand/put pressure on it caused me come over sick and faint but the only time it really felt painful was when the doctor poked either end of the tendon. I've just updated the 'snip' thread
HellsBells Jul 2015 3:19pm, 27 Jul 2015 19,546 posts	0 HellsBells patient.info hope that helps
Molesy Jul 2015 4:14pm, 27 Jul 2015 2,220 posts	0 Molesy Thanks HB, quite a good summary. Given the consensus seems to be toward early mobilisation I rang the orthopaedic unit at my local hospital earlier and explained what had happened, they didn't want to know, "when you get back see your GP and he may refer you to us or to A&E". Now considering I was already seeing them about problems with my Achilles and I'm not entirely convinced that the last injection into my bursa wasn't straight into the base of my Achilles anyway, which is one of the risk factors, I wasn't best impressed.
Hallcross Jul 2015 4:37pm, 27 Jul 2015 4 posts	0 Hallcross Had mine repaired mid April. Been having problems since last August Mine wasnt a sudden rupture, gradual process with running with bad tendinitis for a long time. 16th November 2014 my last run Skegness 10K, got round but so sore, limping since then. Worse thing I had was a cortisone Jab, all agree without laser guidance makes thing worse 24th Jan Mis diagnosed and only X rayed and told to carry on X training, stretching etc, tendon probably hanging on my a thread then ! 6th Feb, spasm and I saw the achilles area suck into towards the front of my leg, so painful. Hobbling and finally got a scan 16th Feb, doctor rang me hours later said it was bad. Hobbling for next few weeks with a defined gap in my tendon 16th April Operation, opted for local anaesthetic, spinal block 2 weeks plaster cast no weight bearing, toe pointing down a bit. 29th April fitted with boot, set at an angle downwards, non weight bearing and sleep with it ! a few weeks set flat and some weight bearing In total about 8 weeks immobile Gradual walks when boot off 29th May 3 mile walk, awful to see how small calf is though ! 15th June on my road bike gradually building up Now doing 28 miles every other day and walking up to 6 mile with hardly a limp, calf coming back nicely. Also doing step ups with weights and lots of stretches etc Post op I only had pain killers for 2 days and have had no pain, just inflamed tendons top of foot for a while. I have some great pics with about 15 stitches, mine was so bad they used a tendon from my big toe to bridge the gap as left too long My plan is to try a run mid October on my 65th birthday in Cyprus, running 35 years so miss the buzz ! Just take it easy and listen to people, hospital physio useless, I go by what I have gleaned from others and by how it feels.
Molesy Jul 2015 5:17pm, 27 Jul 2015 2,223 posts	0 Molesy Thanks Hallcross, I really appreciate that. It's good to know it's possible to come out the other side. I'm absolutely horrified though that it took 8 weeks from scan to operation mine went late afternoon last Monday and at 1000 the following morning I was being operated on. Rather you than me on the spinal block too, I had the option of general, spinal block or single leg block and took the general option. While they're screwing things into my heel and rummaging around up my leg to find the end I don't want to know anything about it. It definitely sounds like I need to be pushing for an ortho appointment ASAP though, according to the French plan it'll be another 5 weeks before I get the cast off. I've been lucky on the pain front too, the strongest thing I've had is a couple of Paracetomol. Post-op were you on any anti blood clotting meds? They've got me on daily injections of a drug called Innohep for 45 days post-op which seems rather excessive but at least they've taught me how to do it myself.
Flatlander Jul 2015 5:35pm, 27 Jul 2015 195 posts	0 Flatlander Since you're going to be fairly immobile for several weeks, you are at an increased risk of developing DVT, so you are being given heparin, an anticoagulant, to reduce that risk during your immobility. Hope you recover as well as Hallcross has.
Molesy Jul 2015 6:14pm, 27 Jul 2015 2,224 posts	0 Molesy Thanks Flatlander, that explains why it's necessary for so long. Is that normal procedure in the UK or a French thing?
Footpad Jul 2015 8:13pm, 27 Jul 2015 5,918 posts	0 Footpad Oh crap Molesy! Hope it gets all mended soon. I have been avoiding Fetch as I cannot run with a possibly stress fracture of the tibia.... bugger this getting old lark