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RESULTS of the trial
Achilles tendon rupture affects over 11,000 people each year in the UK, leading to prolonged periods away from work, sports and social activities. Traditionally, after a ruptured tendon, the foot and ankle is held still in a plaster cast for eight weeks or more. Functional bracing is an alternative treatment which allows patients to mobilise sooner, but there is little evidence about how it affects later recovery.
This study was to compare traditional plaster casting to functional bracing for adult patients with an Achilles tendon rupture. The participants reported their own recovery using the Achilles Tendon Rupture Score (ATRS) which consists of 10 questions about symptoms and physical activity, where 100 is the best possible outcome. We also recorded quality of life, complications including re-rupture of the tendon, and costs from both the NHS and patients’ perspective.
540 patients, treated at 39 hospitals, agreed to take part and were assigned by chance to either plaster casting or functional bracing. Patients reported their recovery at 8 weeks and 3, 6 and 9 months.
What did the trial find?
Patients recovered steadily after their injury but were still not back to normal at nine months. The average ATRS score rose from 38/100 at 8 weeks to 73/100 at nine months.
Patents who had the functional brace reported that their recovery was a little better at 8 weeks than the patients having the plaster cast, but there was no evidence of a difference after that. There were 17 cases of re-rupture of the Achilles tendon in the Plaster Cast group and 13 in the Functional Brace group. There was no evidence of a difference in costs.
In conclusion, this study provides strong evidence that early weight-bearing in a functional brace provides similar outcomes to traditional plaster casting and is safe for patients having treatment for an Achilles tendon rupture.