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Aquille Tendon,rerupture.Second Surgery Needed?

Posted on Sun, 27 May 2012

Question: I had aquille tendon repair 6weeks ago and suffered an rerupture by tripping with my crutches. do u recommend a second surgery? I tore my wound also back open only about a half of inch, and dr.s say i should get the surgery and its possible they might have to do a tendon transfer from big toe. I dont really want a second surgery I wanna lean towards the non operative approach which is to cast for several weeks and let it heel by itself...also im trying to stay away from them messing with my big toe for transfer...I also hear they can use a graft as well...please let me know ur opinion....Im 35 years old, no medical complications, 5'10inches tall,.

Answered by Dr. Dr. Rakhi Tayal (58 minutes later)

Hello.
Thanks for writing to us.

Since you have reopened your wound and reinjured your tendon, the best treatment would be a tendon transplant. It is an old injury and is difficult to heal with a conservative management like plaster.

Going for a plaster will be time consuming- might take several weeks and even then might result in non healing after which you might have to go for surgery again.

Also, plastering will cause disuse stiffness of your joints of the foot which will need physiotherapy for another at least two weeks for you to walk normally.

Surgical treatment will put you on your feet earlier making your quality of life better.

The final decision of course is yours but i will suggest you to think deeply before deciding anything.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Wishing you good health.
Regards.

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Dr. Rakhi Tayal (12 hours later)

I thought I was asking an Orthopaedic surgeon my question...Is their anyway I can get an answer fro them since this is not your expertise? I stated earlier that this was not and old surgery, this was recent (6 weeks ago) this is not an old wound it is very recent.....

Answered by Dr. Dr. Rakhi Tayal (32 minutes later)

Hello,

Thanks again for following up.

A wound or surgery that happened six weeks ago is considered as an 'old wound' surgically.
Fresh wound is mentioned in terms of hours not in days or weeks.

I had a few discussion with an orthopaedician working in my hospital.

"A curbside consult from a second orthopaedician (my husband) was done here too". They agree with my advice too and they give similar opinion.

Hope my answer is helpful and informative.

Wishing you a trouble free speedy recovery.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Rakhi Tayal (5 hours later)

Ok Thank you!
The last question I have is if I do not decide to have the surgery, what is the advantages vs. the disadvantages...I know their is a non operative approach to this surgery as well, I know about the rerupture percentage rate....but is their a good chance I would heal properly? My surgery is tomorrow if i take it or not that why im trying to get as many more opinions as possible....This is all the questions I get to ask, please inform me as much as you can this time...Thank you

Answered by Dr. Dr. Rakhi Tayal (2 hours later)

Hi.
Thanks for the follow up.

If you are already scheduled for surgery tomorrow then my suggestion would be to go for it.

Conservative treatment will take at least 6-8 weeks of plastering and even then may not heal. The recovery depends on your own body's capacity to heal.

It is delayed with poor nutrition, associated diseases like infections, diabetes, lack of rest, decreased blood circulation, etc.

Your quality of life will be much better with early recovery if you go for a surgery.

Wishing you good health.
Regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Radhika