Achilles Tendon Rupture

Management of Achillies Tendon Rupture (Adult 18+only)

Clinical Examination

Patient presents to ED with ankle/calf injury with a typical mechanism

• Forced dorsiflexion from plantar flexed foot
• Forced Push off

Special tests for Achilles Tendon Injury

Simmonds Triad of tests:

• Palpable gap
• No plantar flexion on calf squeeze test
• Altered angle of declination/"dangle2 (injured side different to uninjured side when relaxed)

2+ Clinical Signs are positive

NO Ultrasound Scan

• Next Day NPC
• Equinus below knee backslab
• NWB, crutches
• VTE assessment (See  OFTEN scoring)
• Safety netting advice
• Give patient Achillies tendon rupture advice leaflet 

<2 Clinical Signs, Clinical uncertainty, All other differential diagnoses ruled out

• Book MSK ultrasound scan (within 72hrs)
• Arrange NPC appt for after the USS
• Equinas backslab
• NWB, crutches
• VTE assessment (See OFTEN scoring)
• Safety netting advice
• Give patient Achillies tendon rupture advice leaflet