Acute Achilles tendon rupture in a 38-year-old recreational athlete is confirmed by a positive Thompson test. Conservative management with functional bracing results in a re-rupture rate compared to operative repair of approximately:

• A Lower re-rupture rate with conservative management but higher infection rate
• B Higher re-rupture rate with conservative management but lower complication rate ✓
• C Identical outcomes between operative and conservative management in all patient groups
• D Conservative management superior in all age groups

Explanation

Meta-analyses and RCTs consistently show that operative repair of acute Achilles tendon rupture has a lower re-rupture rate (~3–4%) compared to non-operative functional rehabilitation (~10–12%), particularly in young active patients. However, surgery carries higher rates of wound complications, infection, sural nerve injury, and deep vein thrombosis. Modern functional rehabilitation protocols (early controlled motion in a walking boot) have significantly narrowed the gap in outcomes. Current guidelines suggest operative repair for young, athletic, high-demand patients and non-operative for older/sedentary or those with high surgical risk. The Thompson test (calf squeeze) confirms complete rupture when no plantar flexion occurs.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.