Tag Archives: achilles

Diagnosing Complete Achilles Tendon Rupture

27 Aug
Calf-squeeze method (Thompson and Doherty Test):
With patient laying prone, squeeze the calf.

Lack of passive plantar flexion of the foot when calf is squeezed indicates rupture of the Achilles tendon

Needle Test (O’Brien):

Insert a 25-g needle at a right angle through the skin of the calf just medial to the midline, 10cm proximal to the superior border of the calcaneus.

Passively plantar and dorsi-flex the foot.

If the tendon is intact, the tip of the needle should move inferiorly with the tendon when foot is dorsi-flexed, and the hub should move superiorly. Opposite with plantar-flexion.

Lack of expected needle movement when foot is passively plantar and dorsi-flexed indicates complete Achilles tendon rupture.


Submitted by M. Smith.

References: O’Brien T. The Needle Test for Complete Rupture of the Achilles Tendon. J Bone and Joint Surgery, 66-a (7), 1984.