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Ankle Position Reduces Gap in Ruptured Achilles Tendon

Last Updated: December 29, 2011.

Ultrasound assessment reveals that maximum ankle equinus alone significantly improves the gap distance after acute Achilles tendon rupture, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

THURSDAY, Dec. 29 (HealthDay News) -- Ultrasound assessment reveals that maximum ankle equinus alone significantly improves the gap distance after acute Achilles tendon rupture, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

Assad A. Qureshi, M.Sc., M.R.C.S., of the Leicester Royal Infirmary in the United Kingdom, and colleagues used dynamic ultrasound to study 26 patients (mean age, 41 years) with a unilateral acute complete Achilles tendon rupture. The mean distance of the rupture from the calcaneal enthesis was 52 mm (range, 40 to 76 mm). Ultrasound scans were used to measure the gap distance between the superficial tendon edges with the ankle in neutral and the knee extended. The gap distance was sequentially measured with the foot in maximum equinus at the ankle and with knee flexion of 0, 30, 60, and 90 degrees.

The researchers found that the mean gap distance with the ankle in neutral and the knee extended was 12 mm. When the foot was placed in maximum ankle equinus, the mean gap distance decreased to 5 mm with 0 degrees of knee flexion, 4 mm with 30 degrees of knee flexion, 3 mm with 60 degrees of knee flexion, and 2 mm with 90 degrees of knee flexion. Expressed as a percentage, there was a reduction in mean gap distance of 55.7, 64.4, 75.4, and 84.8 percent with maximum ankle equinus and 0, 30, 60, and 90 degrees of knee flexion, respectively, all of which were statistically significant.

"Maximum ankle equinus alone significantly reduces the gap distance after acute Achilles tendon rupture. Increasing knee flexion further reduces the gap distance by small increments that, although significant, may not be clinically important," the authors write.

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