Functional Bracing and Plaster Casts Yield Similar Outcomes for Achilles Tendon Ruptures

Recent studies of Achilles tendon ruptures show that surgical and nonsurgical management produce similar functional outcomes, and nonsurgical management is increasingly preferred by clinicians and patients. Traditionally, nonsurgical management has involved serial non–weight-bearing plaster casts with gradually decreasing plantar flexion (and increasing stress on the tendon as it heals). Another option is “functional bracing”: a removable walking boot with gradually decreasing heel wedges. But functional outcomes with these two approaches have not been compared.

British researchers randomized 540 patients with recent Achilles tendon ruptures who elected nonsurgical management to receive plaster casts or functional bracing. After 8 weeks of t…