Approximately one-fourth of Achilles tendon ruptures are missed during initial examination. However, for most patients, the prognosis is favorable, according to a new study.

The clinical review, from researchers at Rowan University School of Osteopathic Medicine and the Rothman Institute of Jefferson Medical College, was published in the November edition of The Journal of the American Osteopathic Association.

It notes that most patients who experience Achilles tendon rupture healed better with conservative treatment. Surgery should be reserved for acute tears in young or very active patients, per the release.

“As an osteopathic physician, we approach treating injuries with the least amount of surgical intervention possible,” says Joseph N. Daniel, DO, clinical associate professor of orthopaedic surgery at Jefferson Medical College in Philadelphia, one of the study’s authors, in the release.

“Injuries of the Achilles are no different, and this study validates that most patients are better off with conservative treatment,” he adds.

Daniel notes in the release that surgical intervention in younger, athletic patients is associated with lower rates of re-rupture and a quicker return to activity. Diagnostic imaging, such an ultrasound or MRI, is not recommended unless rupture is suspected.

Achilles injuries are somewhat less common among non-athletes but frequently afflict the elderly and sedentary, as well as patients who’ve gained significant weight or started an exercise regimen in middle age. Ruptures are associated with autoimmune disease, plantar fasciitis, obesity, certain antibiotics, smoking, and localized steroid injections, the release explains.

In acute cases, patients often report hearing a popping sound at the time of injury. Chronic ruptures and other Achilles injuries typically involve heel pain or discomfort that coincides with physical activity. Primary care physicians are urged to evaluate those with similar complaints for Achilles injuries and take a conservative approach to treatment, per the release.

“Mismanaged or neglected injuries will markedly decrease a patient’s quality of life,” Daniel states. “In all but a select few cases, we can resolve the issue with rest, over-the-counter medication, physical therapy, or a few weeks in a walking boot.”

[Source(s): The Journal of the American Osteopathic Association, Business Wire]