Rupture of Tendo Achillies
Rupture of Tendo Achillies is the rupture of Achilles’ tendon. The Achilles’ tendon is made of 5 separate tendons. However the gastrocnemeus tendon and the superficial digital flexor tendon are most important.
The gastrocnemeus tendon is most commonly torn. The typically sign of a gastrocnemeus tendon tear is a dropped hock and curling of the toes.Surgical treatment involves repairing the tendon and supporting the limb in a cast for about 2 months.
Anatomy of the Tendo Achillies
The Achilles’ tendon is made of five tendons; four of these tendons attach to the heel or calcaneous bone and one goes over the back of the heel bone to the toes of the hind limb.
Components of the Achilles’ tendon
- Gastrocnemeus tendon – the main tendon that attaches to the heel or calcaneous bone
- Superficial digital flexor – second main tendon that partially attaches to the calcaneous bone and then passes over the end of the heel bone and attaches to the digits; this tendon flexes the digits
- Three minor tendons
Achilles’ tendon ruptures can be partial or complete.
Clinical signs
Partial rupture
- Usually involves rupture of the gastrocnemeus tendon and not the superficial digital flexor
- Dropped hock
- Curled toes (called a bear claw stance)
- Lameness
- The reason that the toes curl with a partial rupture is that the superficial digital flexor tries to keep the heel elevated; the result is that tension is exerted on the toes causing them to curl
Complete rupture
- Involves rupture of all five tendons and the cause is usually due to a laceration
- The pet will have a completely dropped hock
- Lameness
Diagnosis
- Clinical signs
- Radiography
- Ultrasonography
Treatment
- Surgery is usually recommended
- Splint can be used in case of minor tears
- Heavy tendon sutures and special suture patterns (locking loop) are used to pull the tendons together
- If the gastrocnemeus tendon is torn off of the calcaneous bone, holes are drilled into the bone so that the tendon sutures can be securely fastened
The tendon repair must be supported for 2 months. this support is provided by-
- A cast
- A trans-calcaneotibial screw and cast
- An external skeletal fixator
Potential complications
- Pressure sores from the cast
- Infection
- Breakdown of the repair
Aftercare
Restriction of activity for 3 months to the house; keep on a leash when going outdoors for elimination purposes only.
Hock or ankle joint is kept in extension to keep pressure off of the tendon repair for a period of 2 months.
- External fixator care if this is used for additional support.
- Antibiotic should be administered if prescribed.
- After two months, the cast or the external fixator is removed and a soft padded bandage will be applied for an additional 2 weeks.
Cast care if this is used for additional support-
- Place a plastic bag on cast when dog goes outside and remove when back inside
- The inner padding of the cast needs to be changed every two weeks
Watch for signs of pressure sores-
- Dog is paying more attention to cast i.e. is trying to chew cast off or licking at cast
- Daily, smell the cast for a foul odor
- Daily, look for discharge coming through the cast