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There are many different theories and conflicting views about the etiology and treatment of Achilles tendon rupture. The theory of ischemic and degenerative causes seems to have been most widely accepted, although there are several arguments for other explanations or combinations of theories. The preferred therapeutic modality is open surgical repair by suturing, with postoper­ative cast immobilization. Cast immobilization has been increasingly replaced by the use of orthoses, which allow for effective early functional mobilization. Despite its drawbacks, conservative treatment remains an acceptable alternative to surgery in patients with no specific demands. Among the methods introduced recently, subcutaneus suturing under local anesthesia and the use of functional orthosis, which combines the advantages of conservative and operative treat­ment, has been gaining in popularity. Further stud­ies and analysis of results will be needed to con­firm the true value of various theories and treat­ment modalities.