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9.28 Plantaris Tendon" Rupture


Presentation

The patient will come in limping, having suffered a whip-like sting in his calf while stepping off hard on his foot or charging the net during a game of tennis, or similar activity. He may have actually heard or felt a "snap" at the time of injury. The deep calf pain persists and may be accompanied by mild swelling and ecchymosis. Neurovascular function will be intact.

What to do:

What not to do:

Discussion

The plantaris muscle is a pencil-sized structure tapering down to a fine tendon which runs beneath the gastrocnemius and soleus muscles to attach to the Achilles tendon or to the medial side of the tubercle of the calcaneus. The function of the muscle is of little importance and, with rupture of either the muscle or the tendon, the transient disability is due only to the pain of the torn fibers or swelling from the hemorrhage. Clinical differentiation from complete rupture of the Achilles tendon is sometimes difficult to make. Most instances of "tennis leg" are now felt to be due to partial tears of the medial belly of the gastrocnemius muscle or to ruptures of blood vessels within that muscle. The greater the initial pain and swelling, the longer one can expect the disability to last.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
Jon Handler, MD
Michael Gillam, MD