Hi All,
First time poster here.
I wanted to find out a little more about various NHS trusts treatment of Achilles Tendon Rupture (ATR). I'm especially interested as I get the feeling the treatment on offer to me is not optimal and I wonder if I'm the victim of being under the wrong trust. One that is trying to save costs.
My Background : 44 yo male, healthy and fit, with suspected ATR. currently 3 weeks in short leg cast.
I have an Ultrasound tomorrow (4 weeks after incident). No Surgery being offered at all, Consultant says they only provide conservative treatment with cast as surgery gives to many risks. Treatment is 3x3 weeks of short leg casts, final cast is 90 degree to floor. It seems no load to be applied at all during this time.
My main concerns are :-
(1) Risk of re-rupture seems to be on average 20% with non surgical option.
(2) 1 in 3 patients on non surgical never recover function fully.
(3) No option of Airboot being offered to me.
(4) Various studies show that early restricted mobilisation of ankle in non surgical option reduces chance of RR to same levels as surgical. This will obviously not be available if I'm in cast for 9 weeks.
(5) I don't see how I can be offered a set treatment path prior to Ultrasound.
I've never heard of 3x3 weeks cast only option. What are you being offered? I'm absolutely not going to settle for walking with a limp or a weakened leg because my trust are watching their pennies. I will be taking a private second opnion but also wanted to hear your thoughts?
Thanks
David.
Hi David
Did you had Partial Rupture or full rupture?
Nobody knows until tomorrow. It was a 4 week wait for an ultrasound.
I've been in a cast for the 4 weeks.
So you had a cast without any Ultra Sound ??? Its a Joke!! So its a full rupture?
Hi David
I am also 3 weeks into my rupture, i also was not offered surgery.
When it happened the accident and emergency department put it in plaster right away and told me to make an appointment with the Orthapedic department for a weeks time. I could not get an apointment with them for 11days, anyway i attended my appointment and have also now been give 3 x 3 weeks in plaster with no weight bearing. By the time the plaster comes off i will have had it plaster for nearly 11 weeks. How are you coping ??
Mandy x
Hi Mandy
So strange that NHS is different every where when i had my partial rupture straight away i had x ray then ultra sound and then cast for 2 weeks, after that every 2 weeks fracture clinic visit and they removed cast and put new one.
Today it is been 6 weeks and cast is off and i am walking with normal shoes, just bit tight felling on the calf and tendon Achilles and Cons said its normal
Imran
I don't know if its a tear or a rupture. Nobody knows until I get my Ultrasound which is tomorrow.
Oh my God!! Sue them!!!
How can you accept this attitude?
No pain, it's just the inconvenience of it all.
I'm more concerned with the treatment I'm being offered.
Have you had an ultrasound? How did they determine it was a rupture or tear?
Hi Imran
I know the treatment is so different , I was xrayed on the night it happend the see if i had broken anything, but have not been offered an ultra sound or mri scan, it's fantastic that you are walking after 6 weeks
Mandy x
Consultant advise me from xray we cannot view its par rupture or fully rupture
Hi David, i also don't have any pain - as you say just the inconvenience of it all. No i have not had nor been offered an Ultra Sound, they just told me it was an ' Achilles Tendon Rupture ' . They did say that if i had been younger and more athletic then they would have operated, i am 56 years old, but for someone my age the usual treatment is just a cast.
Mandy x
Hi David,
I ruptured my Achilles' just over 7 weeks ago. Protocol is sooooo different everywhere in the world so it seems. I was put in an Airboot straight away until I had a scan which was not until 9 days later. After my ultra sound I was told I did not have a complete tear, although before that I was offered either conservative or operative options and booked in for an op without the scan; I pushed for the scan. My doctor at the hospital said he would op for an op but that's because he prefers that option, I decided againist it. I was then sent home with 4 heel lifts in my boot and told to take one out every 2 weeks, one goes on Wed and then one heel lift left, back to hospital at end of July and Physio booked in a week later. I ahve started doing my own exercises and my foot feel OK. Using one crutch now and with the aid of my wedge shoes to bring my other foot to the right level of the boot can just about do some walking unaided. I feel I am now on the road to recovery but with no aid from the hospital. I would question as to why you are not getting a scan before week 4 and would worry about this as you don't know how bad your rupture actually is. Hope you get sorted quickly.
Karen
Hi David
So sorry for what you're going through atm and that I can't offer you any helpful information.
I haven't actually suffered a ruptured tendon but Tendinopathy in both Achilles' tendons and all other tendons in my ankles and feet. This was due to taking an antibiotic Levofloxacin, in the Fluoroquinolone class and tendon problems, including ruptures, are a common Adverse Reaction - particularly affecting Achilles. This ADR is often delayed, only occurring months after stopping the antibiotics.
I am interested in finding out if people with Achilles' tendons rupture, might be experiencing an adverse reaction, so if you have taken a Fluoroquinolone/Quinolone antibiotic in the last year, I would appreciate if you could let me know.
In the meantime, I wish you a speedy recovery.
plodding on
I've not seen harsh stats like that on non surgical route. Where where the 20 percent and the one in three stats derived? A boot is offered after the cast? At some time right?
I had surgery. I was given a choice. But I was not given information like that.
I'm a 46 year old American. I'm 7 months post opp.
Hi
After surgery did you had inflammation?
Yes a lot of swelling. I've still got some fluid or swelling in my ankle now. My Dr said to expect to see some there for up to a year.
From what I have read, early mobilisation is the key to a good outcome and a speedier recovery. So the earlier you are able to do weight bearing the better, which is why many people are given the rigid boots to wear. I had a complete rupture of my Achilles tendon and therefore had to have an operation. I have summarised the treatment I received below:
Following my accident I went to A&E and after being assessed my leg was put in a plaster cast. The following day I attended an outpatient clinic and was given an ultrasound scan which confirmed that it was a complete rupture and that I would need an operation. One day later the hospital called me to say that I was booked in for my operation in two days time. So from having the accident to being operated on was four days. My operation was a day case and I went home with my leg in a plaster cast with crutches and was told to put no weight on my leg whilst it was in the cast. Two weeks later I attended an outpatient clinic, the plaster cast was taken off and I then saw the consultant that operated on me and was fitted with a rigid boot with four heel lifts. I also saw a physiotherapist and was given some very simple exercises to do at home. I wore the boot for thirteen weeks and did exercises at home as specified by the physios. During that time I saw the consultant one more time and had regular pysiotherapy appointments. After the boot was removed, for the next two months I attended regular physiotherapy sessions at the hospital which culminated in six lower limb exercise classes to complete the treatment. I was then signed off by the physiotherapist. It took six months from the accident to completing the treatment.
Do you have inflammation?