achilles tendon tear classification

The Kuwada classification of Achilles tendon tear was proposed in 1990  and at the time of writing (July 2016) remains the most widely used system for describing achilles tendon rupture.

Classification

Achilles tendon tears may be grouped (according to severity of the tear and degree of retraction) into four types:

  • type I: partial ruptures ≤50%
    • typically treated with conservative management
  • type II: complete rupture with tendinous gap ≤3 cm
    • typically treated with end-end anastomosis
  • type III: complete rupture with tendinous gap 3 to 6 cm
    • often requires tendon/synthetic graft
  • type IV: complete rupture with a defect of >6 cm (neglected ruptures)
    • often requires tendon/synthetic graft and gastrocnemius recession
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