Individualized Treatment of Acute Achilles Tendon Rupture

Inclusion Criteria: * Appointment in the Outpatients Department within 4 days of injury. * Total Achilles tendon rupture. * Initial treatment with split cast with the ankle in maximal plantar flexion must be started within 24 hours of injury. * The patient must be expected to be able to attend rehabilitation and post-examinations. * The patient must be able to speak and understand Danish. * The patient must be able to give informed consent. Exclusion Criteria: * Rupture of the Achilles tendon either at the insertion on the calcaneus or at musculotendinous junction of the triceps surae. * Previous rupture of the Achilles tendon in any of the two legs. * Treated with Fluoroquinolones or corticosteroids within the last 6 months. * In medical treatment of diabetes. * Suffers from rheumatic disease. * Other conditions prior to the injury resulting in reduced function of any of the two legs. * Contra-indication for surgery: severe arthrosclerosis with no palpable pulse in the foot, broken skin in the Achilles region of the injured leg. * Inability to lie in prone position on the operating table. * Terminal illness or severe medical illness: ASA (American Society of Anesthesiologists) score higher than or equal to 3.