31 August 2024 at 15:13:34
Arrange urgent outpatient Ultrasound to assess gap size. Walking boot with 3x wedges. Weight bear as tolerated. Supply 4 weeks of prophylactic Dalterparin. (See more for full protocol)
On-line referral to VFC
Clinical presentation
Patient may complain of heel pain / weakness and difficultly walking. Mechanism is often during sporting activities, where the ankle is suddenly dorsiflexed, or with forced plantar flexion (e.g. in jumping). A "pop" may be described by the patient.
Clinical signs / examination
Tenderness at achilles tendon. A gap may sometimes be palpable. Ankle plantar flexion is weak. When squeezing the calf, the ankle may lack plantar flexion. "Thompson/Simmonds test"
Investigations
Ultrasound is main investigation to determine complete vs partial rupture.
MRI maybe useful in chronic ruptures.
A&E management
Please follow MTW NHS Trust VTE Prophylaxis as shown below:
