Figure 2
Matles' test. In the left picture the ankle has an anatomic angle compared to the right where the dorsiflexion of the ankle is increased which is an indirect sign of an Achilles tendon rupture.
Context in source publication
Context 1
... the tendon is ruptured, no plantarflexion of the ankle will occur when squeezing the calf muscle, termed a positive test. There are cases when the tendon from the plantaris muscle is intact which could give a false negative sign and therefore, it is of importance to also perform Matles´testMatles´test (Fig 2) ( Matles, 1975). When performing Matles' test (Matles, 1975), the patient is also in prone position but the knees are bent to 90°. ...
Citations
... The reasons behind the recent increase in incidence rates remain unclear. Still, they could be due to the notable surge in participation in the racquet sport Padel, as racquet sports increase the risk of ATR, 26 with the number of unique individuals booking a court for Padel in Sweden increased from 33 990 to 540 000 between 2017 and 2021. 27 The observed long-term rise in the ATR incidence rate is presumably related to increased participation in sports or recreational activities among women and people at older ages, 28-30 evidenced by the higher incidence in women (58% vs 40% in men) and the shift in median injury age from 44 to 50 years. ...
Introduction
Given the lack of consensus on optimal treatment strategies for acute Achilles tendon rupture (ATR), understanding temporal trends, treatment choice and demographic characteristics is important. Previous research suggests increasing incidence with declining surgical treatment. Current trends in Sweden are not known.
Hypothesis/purpose
To assess how incidence rates, treatment trends and time from injury to surgery (TTS) of ATR have changed between 2002 and 2021 in Sweden, with particular attention to changes since 2012.
Study design
Descriptive epidemiology study.
Methods
We conducted a nationwide register-based study including all inpatients and outpatients ≥18 years of age with an ATR between 2002 and 2021 in Sweden.
Results
53 688 ATRs (78.5% men) were identified during the study period. 15 045 patients (81.5% men) were surgically treated within 30 days. The long-term incidence rate for ATR injury increased by 45%, from 28.8 in 2002 to 41.7 in 2021 per 100 000 person-years (p<0.0001). In the last 5 years of the study, there was a significant, continuing increase in ATR incidence by 21%, from 34.4 in 2017 to 41.7 in 2021 per 100 000 person-years (p<0.0001). The surgical incidence rates decreased from 13.4 to 6.0 per 100 000 person-years (p<0.0001). TTS increased from 0.6 days in 2002 to 5.1 in 2021 (p<0.0001).
Conclusion
The observed increase in incidence rates and decrease in surgical treatment of ATR emphasise the need for evidence-based treatment and rehabilitation protocols for non-operated patients of all ages. A significant increase in time from injury to surgery was observed throughout the study period.
