Advancing practice in Achilles tendon rupture management: thinking beyond the typical
Philippa Dolphin, Paul Mackenney, Chris DrakeBackground
Achilles tendon ruptures (ATRs) are significant lower limb injuries. While typically associated with sporting injuries in middle-aged males, this may not reflect evolving societal demographics. Advanced practitioners now play a central role in ATR management. Understanding patient demographics, injury mechanisms and management choices is essential for shared decision making in the advanced practice setting.
Aims
This article explores the demographics, injury mechanisms and management pathways of patients with ATRs in an advanced practitioner-led service.
Methods
A retrospective 10-year audit of ATRs was conducted in an advanced practitioner-led clinic.
Results
A total of 440 patients were identified: male (347;78.9%), mean age 53.4 years (15–91), 158 (36%) aged ≥60 years. Acute injuries were the most common presentation (355; 80.7%). Chronic presentations were more common in people ≥60 years ( n =46). Sport/exercise was the leading injury mechanism (43.4%). People aged ≥60 years accounted for most low-velocity injuries (83; 66.4%). Conservative management in equinus was most common pathway (331;75.5%).
Conclusions
This audit highlights that people with ATRs represent a diverse population. Notably, one-third of patients were aged ≥60 years and commonly experienced low-velocity (non-sporting) injuries.
Implications for practice
Recognising these distinctions in advanced practice settings is essential to support complex shared decision making, founded on an accurate and timely diagnosis.