Early functional rehab reduces stiffness and deconditioning
Protocol adherence critical to outcomes
Diagnostic strategy
Clinical exam primary in many cases
Ultrasound confirms tear and assesses gap when exam equivocal
Patient Discharge Instructions
copy discharge instructions
Discharge instructions
Diagnosis
Suspected Achilles tendon rupture
Immobilization care
Keep splint or boot on as placed
Keep dry
Do not remove padding or wedges unless instructed by specialist
Avoid ankle dorsiflexion stretching
Activity
No weight-bearing on injured leg unless specialist says otherwise
Use crutches or walker
Elevate above heart as much as possible for 48-72 hours
Ice 15-20 minutes at a time with skin protection
Pain control
Acetaminophen as directed on label
Ibuprofen or naproxen as directed on label if safe for you
Avoid mixing multiple NSAIDs
Follow-up
Orthopedics or sports medicine within 3-7 days
Earlier if wound present or skin concerns
Return to ER now for
New numbness or weakness in foot
Blue or pale toes
Increasing tightness or severe pain not controlled
Splint too tight or painful pressure points
Fever or spreading redness
Drainage or foul smell from wound
Chest pain or shortness of breath
New calf swelling with pain
References
Guidelines and evidence sources
Core guideline and society statements
AAOS guidance on acute Achilles tendon rupture treatment options
Operative and nonoperative both reasonable in many patients
Shared decision-making emphasis
AOFAS position statement on acute Achilles ruptures and early functional rehabilitation
Nonoperative effective for select patients with early functional rehab
Surgical repair reasonable for healthy active patients
Diagnostic accuracy sources
Thompson test performance estimates
Sensitivity about 96%
Specificity about 93%
Physical examination diagnostic accuracy reviews for tendon injury tests
Likelihood ratio reporting for calf squeeze testing
Evidence synthesis and review sources
Meta-analyses comparing operative vs nonoperative outcomes
Rerupture and complication tradeoffs
Impact of functional rehabilitation protocols
Coding references
ICD-10 S86.0 injury of Achilles tendon
ICD-10 M76.6 Achilles tendinitis
SNOMED CT concepts for Achilles tendon rupture and repair procedures
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