A 38-year-old recreational runner develops acute posterior heel pain with an audible 'pop' while sprinting. Examination shows a palpable gap 2–6 cm above the calcaneal insertion and a positive Simmond's (Thompson) test. Ultrasonography confirms complete Achilles tendon rupture. For a young active patient, the preferred management is:

• A Immediate below-knee cast in equinus for 8 weeks
• B Percutaneous ultrasound-guided suture repair
• C Platelet-rich plasma injection and progressive weight-bearing
• D Open surgical repair followed by early functional rehabilitation ✓

Explanation

In young, active patients, surgical repair of complete Achilles tendon rupture provides a lower re-rupture rate (~3–5%) compared to functional conservative management (~8–12%), and permits earlier return to sports and higher-level activity. Open end-to-end repair followed by an accelerated functional rehabilitation protocol (early weight-bearing in a boot) is the standard for active individuals. Conservative management with functional bracing is increasingly used in older, less-active patients or those with high surgical risk.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.