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Kuwada classification of Achilles tendon tear

Dr Henry Knipe and Assoc Prof Frank Gaillard et al.

The Kuwada classification of Achilles tendon tear was proposed in 1990 4 and at the time of writing (July 2016) remains the most widely used system for describing achilles tendon rupture. 


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 defect of >6 cm (neglected ruptures)
    • often requires tendon/synthetic graft and gastrocnemius recession

Article information

rID: 6074
Synonyms or Alternate Spellings:
  • Achilles tendon tear classification
  • Classification of Achilles tendon tears

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Cases and figures

  • Case 1: type II
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  • Case 2: type I
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  • Case 3: type III
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