Functional dynamic bracing and functional rehabilitation for Achilles tendon ruptures: a case series

Background: There has been considerable debate surrounding both the surgical and conservative management of Achilles tendon rupture. There is now a trend towards conservative management however there is no consensus on the best method for this. The aim of this study was to evaluate the clinical and functional outcomes of the conservative management of Achilles tendon rupture using functional dynamic bracing within a functional rehabilitation programme.MethodsThis was a case-series (an uncontrolled before-after) study, and 25 participants with acute Achilles tendon rupture were recruited. The intervention was a conservative management programme with functional dynamic bracing and functional rehabilitation. The primary outcome measure was re-rupture. Secondary outcome measures were the change in EQ-5D-5L VAS and index scores between commencement of management and 6 months follow up, and the Achilles Tendon Total Rupture Score (ATRS) at 6 months follow up.ResultsNo re-ruptures occurred in those participants who complied with the programme (0/21). There were statistically significant positive changes in the EQ-5D-5L VAS with a mean (95% CI) difference pre-post treatment of 12.9 (4.2 to 21.6), p = 0.006. The EQ-5D-5L index scores also significantly improved (Wilcoxon signed-rank test p <0.001). The mean (SD) ATRS score at 6 months follow up was 76.9 (19.9). ConclusionsThe results of this study show management of Achilles tendon rupture using functional dynamic bracing within a functional rehabilitation programme produces good clinical outcomes. This study strengthens the evidence base for this conservative intervention in Achilles tendon ruptures.