A slip and a miss

SMART PRACTICE


Clinical history

The patient, a 45-year-old woman, slipped on wet tiles on her veranda and heard a ‘snap’ at the back of her right heel. She consulted her GP who recorded: “Able to flex ankle, no loss of movement. No gap in the Achilles tendon.”

The GP telephoned an orthopaedic registrar at a base hospital to determine how to conduct a Thompson test to check for an Achilles tendon injury. The test gave an equivocal result, but the registrar suggested a ‘wait and see’ approach and did not

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