The correct classification of an Achilles tendon rupture with a palpable gap, positive Thompson test, and inability to perform single-leg heel rise, presenting 6 weeks after injury, is:

• A Acute complete rupture — for primary surgical repair
• B Neglected (chronic) rupture — requires V-Y advancement or turndown flap ✓
• C Partial rupture — conservative management
• D Acute rupture — for functional bracing only

Explanation

Achilles tendon ruptures presenting after more than 4 weeks are classified as neglected or chronic ruptures because the tendon ends retract and fill with fibrotic scar tissue, with a gap typically exceeding 5 cm. Primary end-to-end repair is not feasible. Reconstruction requires V-Y myotendinous advancement (for gaps 2–5 cm), tendon turndown flap (Christensen procedure), or FHL/FDL tendon transfer for larger defects. Functional bracing is appropriate only for acute ruptures.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.