Current concepts review-rupture of the Achilles tendon

N Maffulli - JBJS, 1999 - journals.lww.com
JBJS, 1999journals.lww.com
Achilles, the warrior and hero of Homer's Iliad, lends his name to the Achilles tendon, the
thickest and strongest tendon in the human body138. Thetis, Achilles's mother, made him
invulnerable to physical harm by immersing him in the river Styx after learning of a prophecy
that Achilles would die in battle. However, the heel by which he was held remained
untouched by the water and thus Achilles had a vulnerable point. Achilles led the Greek
military forces, which captured and destroyed Troy after killing the Trojan prince Hector …
Achilles, the warrior and hero of Homer’s Iliad, lends his name to the Achilles tendon, the thickest and strongest tendon in the human body138. Thetis, Achilles’s mother, made him invulnerable to physical harm by immersing him in the river Styx after learning of a prophecy that Achilles would die in battle. However, the heel by which he was held remained untouched by the water and thus Achilles had a vulnerable point. Achilles led the Greek military forces, which captured and destroyed Troy after killing the Trojan prince Hector. However, Hector’s brother Paris killed Achilles by firing a poisoned arrow into his heel164. Hippocrates, in the first recorded description of an injury to the Achilles tendon, stated that “this tendon, if bruised or cut, causes the most acute fevers, induces choking, deranges the mind and at length brings death.” 26 Ambroise Paré, in 1575, recommended that a ruptured Achilles tendon be strapped with bandages dipped in wine and spices, but advised that the result was dubious27. Operative repair of a ruptured Achilles tendon was advocated in 1888 by another Frenchman, Gustave Polaillon27, although an Arabian physician performed such procedures as early as the tenth century AD In the twelfth century, an Italian surgeon, Guglielmo di Faliceto, believed that nature was unable to unite divided tendons and that operative treatment was necessary27.
Much research has been performed to elucidate the etiology of a rupture of the Achilles tendon, but its true nature still remains unclear190. Also, the best method of treatment is still fiercely debated. Some physicians advocate operative repair, whereas others insist that an operation is unnecessary and poses an unacceptable risk.
Lippincott Williams & Wilkins