A 35-year-old man feels a sudden snap in his right heel while sprinting. He can walk but cannot rise onto his toes. Squeezing the calf fails to produce plantar flexion of the foot. The diagnosis and initial management are:

• A Rupture of the gastrocnemius muscle, managed with rest and physiotherapy
• B Plantaris tendon rupture, managed with analgesia alone
• C Rupture of the Achilles tendon, managed with surgical repair or functional bracing ✓
• D Tarsal tunnel syndrome, managed with corticosteroid injection

Explanation

A palpable gap, inability to perform a single heel raise, and a positive Thompson test (absent plantar flexion on calf squeeze) confirm acute Achilles tendon rupture. Treatment in an active patient is either open or percutaneous repair or early functional bracing with controlled mobilisation. Gastrocnemius tear (tennis leg) occurs more distally at the musculotendinous junction with an intact Thompson test, and plantaris rupture does not abolish plantar flexion power.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.