Achilles Tendon Rupture - 45mm Gap: Is Surgery Necessary?
Greetings, Medical Professionals! My mother, who is 50 years old, sustained a ruptured Achilles tendon the previous Saturday. It wasn't until Thursday that she was able to undergo an ultrasound. The results revealed a complete rupture with a staggering 45mm gap between the two ends of her tendon. We visited the emergency department, where she was fitted with a plaster splint for her leg, and the recommendation was to return in a fortnight for follow-up. Based on my research through various medical literature, such a significant gap typically suggests that surgical intervention is essential without delay. What options are available to us?
Answers (1)

8/30/2025, 2:43:27 AM
OpenHealth AI
It’s understandable that you are concerned about your mother’s significant Achilles tendon rupture and the best course of action. Here’s an overview of the situation and the options available.
Main Points
A complete Achilles tendon rupture with a 45mm gap often requires surgical intervention for optimal recovery. While non-surgical treatment is sometimes an option, it may not be suitable for larger gaps like hers.
Explanation
The Achilles tendon, located at the back of the ankle, connects the calf muscles to the heel bone. When ruptured, especially with a large gap, the two ends of the tendon cannot reconnect naturally, which can lead to functional limitations and complications if not addressed properly. Surgical repair typically aims to bring the tendon ends back together, promoting healing and restoring function more effectively than conservative management.
Next Steps
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Consult with an Orthopedic Specialist: Given the size of the gap, it’s crucial to seek evaluation from an orthopedic surgeon who specializes in tendon injuries. They can assess her situation thoroughly and discuss the risks and benefits of surgical repair versus conservative treatment.
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Consider Timing for Surgery: If surgery is deemed necessary, acting sooner rather than later can be beneficial. The longer the tendon is left unrepaired, the more the ends can retract and form scar tissue, complicating future repair.
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Pain Management: Ensure she is managing any pain effectively with over-the-counter pain relievers (like acetaminophen or ibuprofen) according to dosing guidelines, if appropriate and without contraindications.
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Follow-Up Appointments: Adhere to the follow-up appointments as directed by her healthcare team. These visits are essential for monitoring her injury's progress and deciding on the best management strategy.
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Educate Yourself on Post-Operative Care: If surgery is performed, familiarize yourself with post-operative care, including any restrictions on movement, physical therapy protocols, and the expected timeline for recovery.
It's completely normal to feel overwhelmed, but you’re doing the right thing by seeking additional information. Make sure to keep close communication with the healthcare team to ensure your mother receives the best possible care.
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