Bilateral flatfoot before Surgery and  Bilateral flatfoot after Surgery
Ankle Arthroscopy and Subtalar Arthroscopy
Ankle Arthritis in Rhuematoid patient and Ankle Replacement in Rhuematoid Arthritis
Diabetic foot before Surgery and Diabetic foot after Surgery
Claw toe deformity in Rhuematoid patient and Claw toe deformity in Rhuematoid patient after surgery
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Achilles Tendon Surgery in India


Acute Achilles Tendon Rupture

Pain in the lower calf, which comes on suddenly during a sporting activity or after an injury. You might hear a snap or pop when the tendon is torn. The sharp pain usually settles quickly, although there may be some aching at the back of the lower leg. After the injury, the usual symptoms are:

1. A flat footed type of walk. You can walk and bear weight, but cannot push of the ground properly on the side where the tendon is ruptured.
2. Inability to stand on tiptoe.
3. If the tendon is completely torn, you may feel a gap just above the back of the heel. However, if there is bruising then the swelling may disguise the gap.

If you suspect an Achilles tendon rupture, it is best to see a doctor urgently - because the tendon heals better if treated sooner rather than later.

Treatment

Non surgical Treatment

While it is possible to treat this ruptured tendon without surgery, this is not ideal since the maximum strength of the muscle and tendon rarely returns. The reason for this is that the ends of the tendon retract after tendon rupture. This gap so created because of retraction is filled with scar tissue at the time of healing.

As a result the tendon never gets the mechanical strength it has before injury. This results in weakness of leg after injury.

However there are patients for whom surgery cannot be performed, in particular, due to existing medical conditions which may add to potential for complications following surgery. For these patients, I use a specially designed boot which positions the foot correctly, and takes the pressure and tension off the muscle and tendon. Rarely if this is not available - a below plaster treatment is advised. Plaster is usually given for a period of 6 weeks and is changed every 2 weeks.

Surgical Treatment

Surgical correction of the ruptured tendon is almost always necessary. This is performed in order to regain the maximum strength of the Achilles, as well as the normal pushing off strength of the foot. The strength of the muscle depends on the correct tension between the muscle and the tendon. The only way that the correct tension on the tendon can set is by accurately repairing the tendon ends.

There are old fashioned techniques for repairing the tendon which require very long incisions (4-6 inches) on the back of the leg.

 
Acute rupture of Achilles Tendon
   
       

Fortunately, now there is a new minimally invasive percutaneous method available for operating on and repairing the tendon. This new method requires only tiny incisions of one to two centimeters in length. This is far more accurate surgery. Recovery after this procedure is easier and the surgical complication rate is extremely low.

 
Achilles tendon minimally invasive repair
  Picture after percutaneous repair with no scars

Picture on the left showing small incisions for minimally invasive achilles tendon repair. On the right is a picture showing result after such a repair on the right foot. Look at small size of scars.