Achilles Tendon Rupture

　　The causes of spontaneous rupture may be multifaceted, including congenital collagen abnormalities, infectious diseases, rheumatoid and immune diseases, endocrine diseases, abnormal neurological function, abnormal hormone levels, reduced blood supply to the Achilles tendon after age increases, degeneration of the Achilles tendon due to excessive exercise, use of corticosteroids or fluoroquinolone drugs such as norfloxacin, high temperature, and tendinous calcification, all of which can lead to spontaneous rupture of the Achilles tendon.

　　In addition to its clinical manifestations, Achilles tendon rupture can also cause other diseases. The complications of this disease often occur after surgery and include the following:

　　1. Repeated rupture of the Achilles tendon

　　2. Deep infection

　　3. Superficial infection and skin necrosis

　　4. Wire breakage

　　5. Stiffness of the ankle joint

　　Common spontaneous Achilles tendon ruptures in clinical practice generally occur in one limb. This rupture can occur at the junction of the Achilles tendon and calcaneus, the junction of the Achilles tendon and the muscle belly, or in the tissue of the Achilles tendon itself. More than 70% of spontaneous ruptures occur during exercise, and patients often engage in ball sports such as badminton, basketball, football, tennis, or track and field sports such as running.

　　Patients themselves may feel as if someone has hit the heel with a stick or kicked it, which is actually the self-perception of an Achilles tendon rupture and is not truly caused by such an external injury. Patients generally do not have significant pain but immediately experience limping and inability to rise on the toes. Subsequently, swelling and ecchymosis above the heel may appear.

　　Due to the swelling after the injury that conceals the indentation caused by Achilles tendon rupture, the presence of the plantar fascia and the flexor hallucis longus allows the ankle joint to partially compensate for the strength of the plantar flexor muscle, enabling walking. X-ray examination also shows no fracture, and some patients or even some doctors may consider it a simple soft tissue injury and miss the diagnosis, thereby delaying the treatment opportunity.

　　1. Choose appropriate physical exercise projects based on your own body condition, such as weight, age, and health status. If you are overweight, it is recommended to avoid intense exercise and do more aerobic exercises such as swimming, brisk walking, jogging, and cycling.

　　2. Before engaging in sports, it is necessary to do warm-up exercises, such as warming up and stretching joints, ligaments, and muscles.

　　3. Prolonged inactivity can lead to decreased body coordination and flexibility, reduced blood supply in the tendons, tissue changes, and a decrease in the tensile strength of the Achilles tendon. If you suddenly engage in剧烈 exercise, it is easy to cause injury. Therefore, physical exercise should be progressive.

　　4. When engaging in intense competitive sports, always do so within your limits, do not force yourself, and do not compete for victory or defeat. It is better to lose than to harm your Achilles tendon and not protect it.

　　5. If you are of O-negative blood type, or have a history of long-term use of quinolone antibiotics, hormone use, Achilles tendon hormone blockage, ankylosing spondylitis, rheumatoid arthritis, gout, and other diseases, you should pay more attention.

　　Common imaging examinations include ultrasound and magnetic resonance imaging. Ultrasound is currently the most precise diagnostic method for diagnosing Achilles tendon rupture. By observing the continuity of the Achilles tendon fibers, ultrasound can not only determine whether the Achilles tendon is ruptured but also identify the location of the rupture, which helps determine the treatment plan.

　　The main component of tendons is collagen. To recover faster and better, it is advisable to eat more foods rich in collagen. For example, the skin and tendons of animals. Generally speaking, pork skin and pork tendons are very good.

　　Since the tendons have not been repaired and truly healed, it is strictly forbidden to eat chicken, beef, ginger, and other spicy, fried, and fried foods, as well as strong alcohol and other indigestible and irritating foods.

　　Acute Achilles Tendon Rupture

　　Acute Achilles tendon rupture can be treated with conservative treatment and surgical treatment.

　　Conservative treatment mainly involves immobilizing the ankle joint in an extreme plantar flexion position with plaster for 4 weeks to allow the ends of the Achilles tendon to contact and heal spontaneously. During this period, strict crutch walking is required, and the affected limb must not bear any weight, nor can there be any contraction of the calf muscles. After that, the brace is fixed for another 4 weeks to ensure sufficient healing.

　　Surgical treatment usually refers to suturing the two ends of the Achilles tendon, fixing the ends of the Achilles tendon with sutures to achieve sufficient firm contact, and then immobilizing it with plaster for 4-6 weeks to allow the ends of the Achilles tendon to heal sufficiently.

　　Old Achilles Tendon Rupture

　　First, Conservative Treatment

　　The treatment methods for old Achilles tendon ruptures are mainly conservative treatment and surgical treatment. For elderly patients, if they can accept a limping life, conservative treatment can be performed, and braces can be worn to improve function. However, for young patients, most cannot accept the result of lifelong limping, and surgical treatment can be adopted.

　　Second, Surgical Treatment

　　There are many surgical treatments for old Achilles tendon ruptures, which can be roughly divided into two categories:

　　1. Utilizing the tissue at the ends of the Achilles tendon: The muscle of the lower leg (near the end of the Achilles tendon rupture) is flipped to compensate for the ends, or the muscle is split and pulled down to allow the ends to match (V-Y repair). However, this method has a large trauma, high operation difficulty, extended operation time, and increased complications. The distance that can be repaired is relatively short, and the tissue available for repair is thin and scarce. In addition, this method will damage the normal tissue near the end, which may lead to re-tearing of the Achilles tendon near the end.

　　2. Tendon Transplantation: This method uses normal tendon tissue from surrounding or other locations to replace the defect between the two ends of the Achilles tendon, which can minimize the difficulty, operation time, and complications of the surgery. The graft can be selected according to the length of the defect to ensure that there is enough tendon tissue in the defect area.