In Achilles tendon rupture, which management approach constitutes non-operative care?

In Achilles tendon rupture, which management approach constitutes non-operative care?

• A. Immediate range of motion with immobilization in neutral
• B. Complete immobilization in plantar flexion for 12 weeks
• C. Serial splinting in mild plantar flexion with gradual dorsiflexion toward neutral
• D. Surgery with immobilization in neutral

Answer: (C)

Healing after an Achilles rupture is best supported by protecting the tendon with a position that keeps it shortened and reducing tension, then gradually restoring length as the tissue heals. Using devices like serial splints or braces in mild plantar flexion provides that protection early on while allowing controlled progression toward neutral. This staged approach helps align new collagen fibers and minimizes the risk of a re-rupture while avoiding the stiffness and weakness that can come from either rigid immobilization or premature motion. Immediate motion in neutral would place too much stress on the rupture site too soon, and complete immobilization in plantar flexion for a long period is more about passive protection but can lead to significant stiffness and loss of function. Surgery is an operative option, but the non-operative pathway that uses gradual dorsiflexion from a plantar-flexed position is the strategy that best fits conservative management.

Healing after an Achilles rupture is best supported by protecting the tendon with a position that keeps it shortened and reducing tension, then gradually restoring length as the tissue heals. Using devices like serial splints or braces in mild plantar flexion provides that protection early on while allowing controlled progression toward neutral. This staged approach helps align new collagen fibers and minimizes the risk of a re-rupture while avoiding the stiffness and weakness that can come from either rigid immobilization or premature motion. Immediate motion in neutral would place too much stress on the rupture site too soon, and complete immobilization in plantar flexion for a long period is more about passive protection but can lead to significant stiffness and loss of function. Surgery is an operative option, but the non-operative pathway that uses gradual dorsiflexion from a plantar-flexed position is the strategy that best fits conservative management.