Kuwada classification of Achilles tendon tear

Last revised by Henry Knipe ◉ on 20 Mar 2025

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Rasuli B, Bell D, et al. Kuwada classification of Achilles tendon tear. Reference article, Radiopaedia.org (Accessed on 21 Mar 2025) https://doi.org/10.53347/rID-6074

DOI:

https://doi.org/10.53347/rID-6074

Permalink:

https://radiopaedia.org/articles/6074?embed_domain=external.radpair.com%25252525252525252527%2525252525252525255B0%2525252525252525255D

rID:

6074

Article created:

18 Apr 2009, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

20 Mar 2025, Henry Knipe ◉

Disclosures:

At the time the article was last revised Henry Knipe had the following disclosures:

Micro-X Ltd, Shareholder (past)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Henry Knipe's current disclosures

Revisions:

14 times, by 12 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Sections:

Classifications

The Kuwada classification of Achilles tendon tear was proposed in 1990 ⁴ and remains the most widely used system for describing Achilles tendon rupture ^ref.

Classification

Achilles tendon tears may be grouped (according to the 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