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Achilles Tendon Rupture Treatment - Postcode Lottery?

Posted , 24 users are following.

david97308
david97308

Hi All,

First time poster here.

I wanted to find out a little more about various NHS trusts treatment of Achilles Tendon Rupture (ATR).  I'm especially interested as I get the feeling the treatment on offer to me is not optimal and I wonder if I'm the victim of being under the wrong trust.  One that is trying to save costs.

My Background : 44 yo male, healthy and fit, with suspected ATR.  currently 3 weeks in short leg cast.

I have an Ultrasound tomorrow (4 weeks after incident).  No Surgery being offered at all, Consultant says they only provide conservative treatment with cast as surgery gives to many risks. Treatment is 3x3 weeks of short leg casts, final cast is 90 degree to floor. It seems no load to be applied at all during this time.

My main concerns are :-

(1) Risk of re-rupture seems to be on average 20% with non surgical option.

(2) 1 in 3 patients on non surgical never recover function fully.

(3) No option of Airboot being offered to me.

(4) Various studies show that early restricted mobilisation of ankle in non surgical option reduces chance of RR to same levels as surgical.  This will obviously not be available if I'm in cast for 9 weeks.

(5) I don't see how I can be offered a set treatment path prior to Ultrasound.

I've never heard of 3x3 weeks cast only option.  What are you being offered?  I'm absolutely not going to settle for walking with a limp or a weakened leg because my trust are watching their pennies.  I will be taking a private second opnion but also wanted to hear your thoughts?

Thanks

David.

 

1 like, 109 replies

109 Replies

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  • digmon
    digmon david97308

    Posted

    hi david, i did my achilles in turkey was operated on within 9 hours, got back to belfast, and the main man here, said he never operates only uses conservative treatment, i've spoken to some of his patients and they are all happy with the conservative method, seems to have the same end product, only wish i;d have been home when mine went and i would'nt have this horrendous scar, and would feel more comfortable that further damage hasn't been done, stick with it mate but i know it is worrying
  • ann56885
    ann56885 david97308

    Posted

    I completely agree with your postcode lottery suspicions and I think it's going to get worse. However, I had a friend who ruptured her achilles and her treatment was exactly what has been offered to you. Surgery can carry lots of complications. My friend made a complete recovery but she did what they said and had quite a bit of physio afterwards.
  • samantha_16366
    samantha_16366 david97308

    Posted

    I ruptured my achillies 3 weeks ago , I first started off with an air cast (boot) then couple days later saw consultant who was going to give me ascsn told me to go home and I'll get appointment within week for scan , I get all way home get a phone call telling me to go back straight away to have foot put in back slab , week later I see orthopaedic consultant he did the Thompson test says I've got full rupture and in cast for 4 weeks , it taken off and foot put in another position for another 4 weeks and same again for 10 weeks until I'm in boot and weight barring , I'm only 2 weeks in first cast , no weight baring at all , 
  • tim50stroud
    tim50stroud david97308

    Posted

    Am even more confused than ever; Thompson test and manipulation by consultant confirmed complete Achilles tendon rupture from 7 days ago. No scans. Glos NHS trust. Air boot with 3 wedges, self inject anticoagulant, no weight bearing for 2 weeks, then can take it off for sleep. Next appointment in 28 days to take out a wedge. It is assumed by then it will have rejoined and re-hab can start for the next month. 64 yrs, 1st day of boot and depressed already!
    • tim50stroud
      tim50stroud

      Posted

      1 week in and going steady with boot, crutches and crawling around. Plus I'm self injecting anticoagulants once a day (age 65). Slight needle pains in the tendon area while sitting with foot elevated, not a problem, but i hope its a sign of healing
    • tim50stroud
      tim50stroud

      Posted

      2 week in and I'm getting some minor discomfort / stabbing pains in the rupture site when the foot is  and unmoving, maybe every couple of hours; assuming this is a good sign????
    • tim50stroud
      tim50stroud

      Posted

      4 weeks and the second consultation... its healing well; the gap has closed and I can start careful weight bearing, with crutches for another month. one wedge removed. And I can drive an automatic if work can get me one!
  • samantha_16366
    samantha_16366 david97308

    Posted

    Hi I ruptured my left achillies in August I had 4 weeks in short leg cast , went back to consultant in September, who gave me air cast with 3 heel lifts and told to take one out every week and I should be down to none by time I go back which is this Friday 17 October, and told only weight bare with air cast on , I've not been offered a scan , letter to gp days I had full rupture, problem I have now it's very painful to weight bare and that I have numb big toe and two next to it and have numb patches that come and go on my foot , Gp seems to think it's to do with how foot was in cast and to tell consultant , 
  • brian4109
    brian4109 david97308

    Posted

    Hi David in reply to your post code lottery, I ruptured my tendon in Thailand in Janand had very poor, and very expensive treatment, it went again within 4 months, I have now returned to UK went to see GP, referred to Trauma unit specialist did a thorough check, referred me for an MRI (next month) but said I would need probably require reconstruction with possible tendon graft next appoint 21 Nov after MRI his prognosis was 8-12 weeks in a caste, 12-16 weeks in boot with 6 months Physio after. this is in Worcestershire.
    • flow00G
      flow00G brian4109

      Posted

      Hi Brian sweetness and harmony....You wrote in a post that when you initially popped your AT you were in Thailand and there was martial Law,it was close to 10 months before you got proper treatment....??? I just popped mine yesterday and it has been quite an experience though the long haul of experiences are on the way... Thanks for your posts we all have to breakthrough.....
  • Wholefruit
    Wholefruit david97308

    Posted

    Pleased to find the thread. Ruptured last Friday. Straight to A&E in cast and sent home NWB with crutches. I can't manage the NWB. Trying so hard but arms not strong enough, and neither is other leg. Back to hospital yesterday, after 3 days injury. Didn't see consultant. Registrar said the consultant didn't do the op, but some others did. Told me end rsult was the same. Gone onto the regime of the 3 x 3weeks in cast and then onto walking boot. Absolutely no idea how they know that it is healing. I have had no scans or x-ray. Totally fed up and upset. Single mum to 5 year old. Self-employed and told no driving so no income for the duration. Trying so hard to manage but it feels impossible.

    • tim50stroud
      tim50stroud Wholefruit

      Posted

      The diagnosis and treatment regime sounds pretty familiar; its a tedious process I'm afraid. You can feel the break in the back of the tendon; after 4 weeks it should be gone. You need to call in as many favours as you can.. good luck
    • samantha_16366
      samantha_16366 Wholefruit

      Posted

      I ruptured mine in August , the NWB with crutches was impossible for me due to arthritis etc I ended asking Gp if anything they could do they got an occupational therapist who came and got me a frame a board to go over bath plus perching stools for bathroom and kitchen, even she said it's impossible to none weight bare and hospital should offer frames instead of crutches , 14 weeks on I'm 2nd week into physio which is painful due to plantar fasciitis in feet aswell am now wearing trainers albeit it's undone its a slow process and if your not paitent like me it will drive you mad good luck 
    • Wholefruit
      Wholefruit tim50stroud

      Posted

      That was helpful to know about feeling the break. So that would be a sign for doctor that it is healing. Reassuring to have your message - thank you. 
    • Wholefruit
      Wholefruit samantha_16366

      Posted

      Hi Samantha. Snap - also got some OA in lower back and the NWB isn't working. I manage 2 hops and thats it. To be honest - worried about doing more damage to orher leg too! I actually AM an Occupational Therapist and was a bit shocked nobody referred me to one. Its hard to think for myself when in shock from the injury. Thankfully my friend owns a mobility shop so has lent me some things and some i've bought. I'm also finding the bath-board and perching stools brilliant. I'm going to try a wheeled zimmer frame today - see if thats any easier. Sorry to read about the plantar fascilitis - thats really painful. 
    • tim50stroud
      tim50stroud Wholefruit

      Posted

      I've been using a Limbo Products waterproof cover for showers, can recomend their service, gel pads for the crutch handles. Was offered a walking frame but didnt want to feel too immobilised.
    • samantha_16366
      samantha_16366 Wholefruit

      Posted

      Hi glad you've got few thinks sorted , I too couldn't do anymore than about 2 hops and like you worried I'd do damage to other achillies as pain I was getting in it, we ended up buying a wheelchair we did start of by hiring one from mobility shop but at £10 a week it worked out cheaper in the long run , I'm now 14 weeks into recovery only just started pottering around house in trainers and one crutch but wheelchair if need to go out shopping etc 
    • tim50stroud
      tim50stroud samantha_16366

      Posted

      I spent a lot of time crawling round the house, particularly getting up and down stairs; amazing how much more cleaning you can see you missed from a new perspective. Also found the battery scooters in tesco are great fun!
    • samantha_16366
      samantha_16366 tim50stroud

      Posted

      I also had to crawl up and downstairs OH got me a commode on wheels as husband was carrying wheelchair upstairs so I could get to bathroom etc 
    • michelle54444
      michelle54444 Wholefruit

      Posted

      I ruptured both mine at same time spent 12 weeks in cast in a wheelchair and crawling....had em off 4 weeks ago sent home with a zimmer, week later crutches had physio referred for 6 sessions of hydro then 6 weeks off gym...no scans no op but 4 weeks down line walking round house no crutches get up and down stairs ok and now driving. Back to fracture clinic next week for another consultation bug so far going well.....beginning to walk flat footed .....but most of time a small heel.....still get aches and pains and swelling
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