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Achilles tendon rupture — RCPSC EM MCQ

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HardMusculoskeletalAchilles tendon ruptureRCPSC EM

A 63-year-old felt a sudden pop in the calf while climbing stairs and cannot push off. The calf-squeeze test supports Achilles rupture; ankle radiographs show no fracture. What is the most appropriate initial management?

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Correct answer: C — Immobilize in plantar flexion with crutches and orthopedic follow-up

The best answer is “Immobilize in plantar flexion with crutches and orthopedic follow-up”. Achilles rupture is usually a clinical diagnosis. Initial ED care is analgesia, immobilization in plantar flexion or a boot with heel raises, non-weight-bearing and timely orthopedic review. MRI or ultrasound can help only when the diagnosis is uncertain; neutral immobilization, early strengthening and unsupported weight-bearing risk tendon lengthening or reinjury.

Reference: Emergency Care BC: Achilles Tendon Rupture: https://emergencycarebc.ca/clinical_resource/clinical-summary/achilles-tendon-rupture/