Rabun S. Fox, MD

The patient is a 76-year-old man with a history of coronary artery ectasia on Coumadin (warfarin, Bristol-Myers Squibb), hyperlipidemia, hypertension and gout, who sustained a right Achilles tendon rupture 5 months prior to evaluation. He was managed non-surgically by another practice using cast immobilization in equinus with gradual dorsiflexion for about 6 to 8 weeks, during which time he was non-weight-bearing. He was transitioned to boot immobilization with a conservative, graduated physical therapy until he was weaned from the boot. At presentation, his shoe wear is normal, but he complains of persistent limitations in his gait, strength, and ability to return to prior activities despite 2 months of physical therapy.