Comparison of ultrasonographic and intraoperative findings in Achilles tendon rupture

The purpose of the study was to assess the value of ultrasonography in the diagnosis of Achilles tendon rupture, by comparing initial ultrasonographic scans and direct intraoperative findings, as well as to follow up the healing process in operatively and conservatively treated patients. Ultrasound examination was performed in 100 patients (91 males and 9 females, with mean age of 46 years) with clinically suspicious Achilles tendon ruptures. Ultrasonographic findings were compared with intraoperative findings. Eighty-eight patients underwent surgery and twelve patients were treated conservatively. Complete ruptures were diagnosed by ultrasound in 88 patients, and partial ruptures in 12 patients. The length of the tendon (Pearson r = 0.973, p < 0.001, Spearman p = 0.972, p < 0.001) and the size of the rupture (Pearson r = 0.940, p < 0.001, Spearman p = 0.905, p < 0.001) measured before surgery by ultrasound and directly during surgery showed a high correlation. Out of 88 operatively treated patients, 86 had a complete rupture and two had a partial rupture. All patients were examined 3, 5, 8, and 12 weeks after injury or after surgery. In the first five weeks, there were statistically significant differences noted between these two groups. Operatively treated tendons healed more quickly, but after eight and twelve weeks this difference had disappeared. Our study showed that ultrasound is an excellent imaging method for confirming the clinical diagnosis of Achilles tendon rupture as well as for following up the process of tendon healing.