A partial or total Achilles tendon rupture can cause debilitating pain and severely limit a person's ability to stay active. Some small tears can be treated with medications and rest, but a major injury often requires surgery to prevent complications. Modern advancements in Achilles tendon rupture surgery have significantly improved patients' chances of making full recoveries, but there are still concerns with the procedure. The most common risks associated with Achilles tendon rupture surgery are poor surgical wound healing, infection, nerve damage, and reinjuring the tendon during the recovery phase. Doctors and surgeons can provide detailed information about how to care for the foot following surgery to reduce risks and ensure proper healing.
There are a couple different approaches to Achilles tendon rupture surgery, and each has its own level of risk. Some small tears can be repaired through a small horizontal incision at the midline of the tendon. A surgeon uses stitches and glues to reattach the tendon, and then sutures the surgical wound. In the case of a major tear, a long, vertical incision is made to give the surgeon better access to the area. After removing damaged tissue, the surgeon uses stitches and wires to secure the tendon into place.
In the first type of Achilles tendon rupture surgery, the major risks are insufficient wound healing and infection. The cut is usually made at or near the spot where shoes make contact with the back of the ankle. Even soft shoes can rub against the scar, causing it to become irritated and possibly break open. Open skin is highly susceptible to bacterial infections. Nurses can try to reduce the chances of poor wound healing by cleaning, dressing, and checking it regularly while the patient is at the hospital. At home, a person should continue cleaning the area and avoid wearing shoes when possible.
When a long vertical cut is made, it is possible to damage or sever nearby nerves. Most surgeons are very experienced and highly aware of the risk, and thus take extra precautions when making incisions around the Achilles tendon. If a nerve is damaged, it can potentially cause temporary or permanent paralysis of the foot.
Another unavoidable risk following Achilles tendon rupture surgery is accidentally reinjuring the ankle. After surgery, the foot and ankle may be swollen, tender, and painful. It is important for a patient to follow his or her doctor's instructions about using crutches and taking it easy for several weeks. Once the ankle starts feeling better, guided physical therapy exercises can help gradually rebuild strength. The risk of future injuries can be kept to a minimum by wearing a supportive brace or wrap.