To the Editor:
The coverage of Achilles tendon ruptures in a recent CME article (published in August 2009) was surprising to me. As a PA in orthopedics my views could be biased, but I think articles such as this one should have more review and control. I hope subscribers of our association's magazine would never treat an Achilles tendon injury without referring the patient to a musculoskeletal specialist. This tendon injury should not to be taken lightly.
I felt that the author's treatment options were severely outdated and reckless compared to today's approach to an Achilles injury. Specialty bracing and early immobilization for improved vascularization, as well as avoidance of plantar flexion contracture, are light years ahead of strict casting protocols, not to mention fibrin (which, at best, is a historical side note).
I understand that pleasing and/or agreeing with each provider's own perspective and treatment protocols is impossible; but if taken literally, the treatments discussed in this article could limit a patient's potential for full or near-full recovery. Articles that discuss treatments should have the date of the resource material reviewed to avoid the above-mentioned issues.
Scott Wilson, PA-C
Editor's note: The article on Achilles tendon rupture was peer reviewed by PAs working in orthopedics and revised by the author based on the reviews. This occurred before we accepted and published the article and represents our usual practice. It is difficult to say how we could have provided “more review and control.” Readers should note also that the references in the article are all quite recent; all but one were published in the past 5 years.