A 35-year-old male sprinter has sudden severe calf pain during a race as if 'hit by a bat'. Examination shows a palpable gap above the heel, Thompson's test is positive (squeezing the calf does not produce plantar flexion). What structure is injured, and what is the Thompson test testing?
- A Plantaris muscle rupture; Thompson's test is specific for plantaris
- B Complete Achilles tendon rupture; Thompson's test demonstrates loss of the gastro-soleus-calcaneal mechanical continuity ✓
- C Peroneus longus tendon tear; Thompson's test assesses peroneal continuity
- D Deep vein thrombosis; Thompson's test identifies calf vein obstruction
Correct answer: B. Complete Achilles tendon rupture; Thompson's test demonstrates loss of the gastro-soleus-calcaneal mechanical continuity
Explanation
Achilles tendon rupture typically occurs 2–6 cm proximal to its calcaneal insertion (the watershed zone of poor vascularity). Thompson's (Simmonds') test is performed with the patient prone and involves squeezing the calf; absence of plantar flexion confirms loss of continuity between the gastro-soleus complex and the calcaneus. Treatment in active patients is surgical repair or functional non-operative rehabilitation, though surgical repair offers a lower re-rupture rate.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.