August 2014

Weight-bearing casts for Achilles tear keep pace with nonweight-bearing

In the moment: O&P

By Emily Delzell

Use of a weight-bearing cast for the nonoperative treatment of acute Ailles tendon ruptchure produces outcomes that are at least equivalent to traditional nonweight-bearing casts, according to a randomized controlled trial from researchers in Auckland, New Zealand.

Eighty four patients with an Achilles tendon rupture sustained within 72 hours were randomized to eight weeks of wearing either a nonweight-bearing cast or a weight-bearing cast fitted with a Böhler iron; those in the latter group were instructed to begin full weight bearing immediately after fitting.

Investigators queried patients about recovery measures at 14 weeks, performed ankle dynamometry at six months, and did additional follow-up assessments at one and two years.

At one year, patients in the weight-bearing group experienced less subjective stiffness than those in the nonweight-bearing group; rerupture rates for the two groups did not differ significantly. There also were no significant differences between groups for time to return to work or sports, recovery measures, patient satisfaction, or pain.

The Journal of Bone and Joint Surgery published the results in July.


Young SW, Patel A, Zhu M, et al. Weight-bearing in the nonoperative treatment of acute Achilles tendon ruptures: a randomized controlled trial. J Bone Joint Surg Am 2014;96(13):1073-1079.

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