American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of treatment might be used for an Achilles tendon rupture?

1. Rest and ice application

2. Immediate surgery only

3. Surgery or immobilization in plantar flexion

4. Only physical therapy

The correct answer is: Surgery or immobilization in plantar flexion

The choice that indicates surgery or immobilization in plantar flexion is considered correct because it encompasses the common approaches to treating an Achilles tendon rupture. In the case of an Achilles tendon rupture, the standard treatment often involves two primary pathways: surgical intervention or conservative management. Surgical repair aims to reattach the torn tendon ends to restore function and strength, particularly valuable in active individuals or those with significant tendon ruptures. On the other hand, for patients who may be less active or have certain medical contraindications for surgery, immobilization in a plantar flexed position can help promote healing. This position allows for better alignment of the tendon ends, facilitating natural healing processes. The treatment plan typically includes a foot and ankle brace or cast that maintains the foot in a plantar flexed position for several weeks, followed by gradual rehabilitation. Other options may lack the comprehensive approach needed for this type of injury. For example, rest and ice application can provide symptomatic relief and are often part of an initial treatment protocol but do not address the underlying structural damage. Immediate surgery only dismisses the option for conservative management, which is valid for certain patients, while solely relying on physical therapy would not be appropriate without prior stabilization of the tendon. Hence, the answer correctly recognizes both surgical