Aetiology
- Usually occurs in over 40s - tendon degeneration
- Tendon rupture may follow a single high energy event, but is often the culmination of recurrent minor tears or following recent tendonitis
Risk factors
Clinical features
Symptoms
- Sudden deceleration with resisted calf muscle contraction (eg lunging at squash) leads to sudden pain (like being kicked in the back of the leg) and difficulty weight bearing
Signs
- Weakness of plantar flexion and a palpable gap in the tendon are usually apparent
- Unable to tiptoe stand
- Positive calf squeeze (Simmonds) test
Investigations
- Imaging: US or MRI can be used to distinguish between complete and partial tears
- US is often easier for patients and allows dynamic assessment
Management
Surgical management
- Suture repair of tendon
- Wound problems can occur with surgery and can be very problematic if healing does not occur