Abstract

ACHILLES TENDON RUPTURE. REHABILITATION TOOLS AND RECOVERY PERIODS – WHAT ARE THEY?

Kazalakova K.* and Spassoff V.

ABSTRACT

Introduction: The Achilles tendon rupture is one of the most common tendon injuries, typically observed in persons of active age. Treatment can be either surgical or conservative. Very often the impact of such a traumatic injury requires a prolonged period of time before the patient is fully re-socialized. Material and Methods: 84 patients received treatment over a period of 7 years; of those, 63 were male and 21 female, aged 29 through 68 (average age: 42.1 years). Of the patient population, 73 had received their injuries doing sports, 9 as a result of falls from heights, and 2 had inflicted self-injuries while operating cutting machinery. During the post-surgery period, the patients underwent re-habilitation: learning to walk using crutches; coping with postoperative swelling; they received treatment of postoperative lesions using physical tools and massage techniques; and underwent mechanotherapy. The aim was maximum recovery of the motion freedom in the ankle joint and restoration of muscle strength, enabling the patients to walk properly without walking aids. Results and Discussion: Statistics of damages to the left/right lower extremity show a 64.8-percent prevalence of the right one. The Achilles tendon rupture was surgically restored using the Krakow technique. Cryotherapy was administered on 82.4 percent of the patients. We did not treat patients with ruptures of both Achilles tendons, nor did we observe any complications or re-ruptures when the surgical technique referred to above had been used. All patients were rated for pain using the VAS scale. Active rehabilitation started after the 4th postoperative week with personalized programs applying individual load increase determined in accordance with the patients, functional capabilities, age, locomotory culture, body weight and other indicators. Complete recovery of physical fitness was observed in 82 percent of the patients by month 4, in 16 percent by month 5, and in the remaining 2 percent, by month 6 after surgery. The medic’s aim is to identify the mechanism of inflicting the damage, the time lapse since it was inflicted and the existence of any predisposing conditions. It is important to assess with a high degree of certainty the functional capabilities of each patient, as well as the proper load that can be placed on him/her at each subsequent stage. Rehabilitation methods and the preparation of individual treatment protocols occupy a crucial place in the comprehensive therapy of the damage, as well as in the re-socialization of the patients and their return to a normal routine. Conclusions: The treatment of this trauma is interdisciplinary with kinesitherapy being the key method for returning the patient to a normal routine. Recovery to active competitive shape usually takes about 4 to 6 months, but with high motivation and very active physical therapy the recovery period may be shortened to something like 3 months.

Keywords: Achilles rupture, kinesitherapy, impaired function.