Summary
Definition
History and exam
Key diagnostic factors
- acute onset of symptoms
- mechanism of injury
- severe pain
- swelling
- bruising
- palpable gap in normal position for Achilles tendon (Achilles tendon rupture)
- positive calf squeeze test (Achilles tendon rupture)
- positive Matles test (Achilles tendon rupture)
- positive biceps squeeze test (biceps tendon rupture)
- positive Hook test (biceps tendon rupture)
- pop sound
- deformity
Other diagnostic factors
- previous injury
- symptom duration more than a few days
- limited ROM
- weakness
Risk factors
- type of sports (basketball, ice skating, soccer, contact sports)
- anatomic variation
- eccentric exercise
- pennate muscle architecture and type II muscle fibers (fast twitch)
- muscle-tendon units that span 2 joints
- previous hx of ankle sprain
Diagnostic investigations
1st investigations to order
- x-rays
- MRI
- ultrasound for nonligament injuries
Treatment algorithm
Contributors
Authors
Staff Orthopaedic Surgeon
Department of Orthopaedics
VA Medical Center
Cheyenne
WY
Disclosures
SNS declares that he has no competing interests.
Assistant Professor
Department of Orthopaedic Surgery
Virginia Commonwealth University
Richmond
VA
Disclosures
VM is an editorial board member, European Journal of Orthopaedic Surgery & Traumatology.
Spinal Clinical Research Fellow
Queens Medical Centre
Nottingham
UK
Disclosures
SRM declares that he has no competing interests.
Dr Senthil N. Sambandam, Dr Varatharaj Mounasamy, and Dr Sakthivel Rajaram Manoharan would like to gratefully acknowledge Dr Issada Thongtrangan, a previous contributor to this monograph. IT declares that he has no competing interests.
Peer reviewers
Assistant Professor
Department of Orthopaedics
University of Virginia
Charlottesville
VA
Disclosures
QC declares that he has no competing interests.
Professor of Trauma and Orthopaedic Surgery
University Hospital of North Staffordshire
Keele University School of Medicine
Stoke on Trent
UK
Disclosures
NM is an author of a study referenced in this monograph.
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