Calf Muscle Atrophy and Muscle Function After Non-Operative vs Operative Treatment of Achilles Tendon Ruptures

ABSTRACT: Fifteen operatively and eight non-operatively treated subcutaneous achules tendon ruptures were randomly selected from 120 surgically and 35 non-surgically treated patients. Their calf muscle function was studied three to five years after treatment. Non-operatively treated patients were found to have a significantly impaired dynamic muscle function of the calf muscles when tested in a specially constructed heel-raise test device. Operatively treated patients did not show any significant impairment of their muscle function. Measurement of muscle area with CT-scanning showed a significant reduction of the calf muscle in the non-operatively treated patient while no such difference could be found in the operatively treated patients. Isokinetic muscle torque did not differ in the two groups of patients, thus Cybexmeasurements do not seem to be a discriminating method in studying muscle function after achules ruptures. On the basis of our findings we recommend that all athletes with achules tendon ruptures be treated surgically. In non-athletes and older patients non-operative treatment might be considered.