Review of permanent medication due topossible effect on existing disease.
Conventional non-surgical therapy methods
Conservative therapy: pointed foot position for several weeks for scar healing by approximation of the tendon ends. Full weight-bearing is recommended from day one. Indication:
Dehiscence (divergence) of the tendon stumps in neutral position < 10 mm and in 20° plantarflexion (flexion in the direction of the sole of the foot) the complete approximation of the tendon stumps is achieved.
Patients with low mobility requirements
Treatment regimen for conservative therapy:
Day 0 – Day 2: Ventral lower leg splint (plastic long sleeve; “to the front of the body”) in 20° plantarflexion (movement of the foot in the ankle joint in the direction of the sole of the foot = pointed foot position/tiptoe gait), elevation, cooling.
Day 3 – 5: special shoe (therapeutic shoe) with 3 cm heel elevation (24 hours daily); training on forearmcrutches (UAGST).
Day 6 – 4th week: full load in the special shoe with 3 cm heel; isometric exercises, massage, possibly lymphatic drainage.
4th week: ultrasound control [fiber reformation around the rupture, tendon thickness 6-8 mm]Palpation: tendon pervasively palpableFunction: flexion against resistance shows the contraction of the gastrocnemius muscle.
5th -6th week: special shoe with 2 cm heel increase; full load for the first time!
7th -8th week: ultrasound control [fiber texture recognizable; tendon thickness 10-14 mm]Function: plantar flexion force against resistance possibleContinued: Special shoe with 1 cm heel, full load
Notice. With conservative therapy, the risk of re-rupture (recurrence of rupture) is higher; furthermore, there is an increased likelihood of persistent (permanent) reduction in strength of plantar flexion.