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Operative treatment of Achilles tendon rupture lowers risk for tendon re-rupture but confers risk for complications (e.g., infection, deep venous thrombosis, sural nerve injury) compared with nonoperative treatment. In this meta-analysis of 10 randomized controlled trials (944 participants) and 19 observational studies (14,918 participants), researchers compared outcomes following operative versus nonoperative management.
Overall, operative compared with nonoperative management was associated with significantly lower risk for re-rupture (2.3% vs. 3.9%). Similar results were obtained for studies that involved early (≤4 weeks) or late weight bearing. However, re-rupture risk was similar among operative and nonoperative groups in studies that e…