The authors declare that they have no competing interests.
NF drafted the manuscript and critically revised it for important intellectual content. HT and KT performed the surgical procedures and critically revised the manuscript for important intellectual content. AH and IS performed histological examinations of the excised specimens and critically revised the manuscript for important intellectual content. SO, MI, and TM provided advice and guidance regarding the surgical procedure and critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.
NF is a professor in the Department of Life Sciences at the Graduate School of Arts and Sciences of the University of Tokyo.
Fracture of an ossified Achilles tendon is a rare entity, and no standard treatment has been established. This is the first report to describe the use of a hamstring tendon graft and gastrocnemius fascia flap for Achilles tendon reconstruction.
We present the case of a 50-year-old woman with fracture of an ossified Achilles tendon. She presented to our clinic with acute right hindfoot pain, which started suddenly while going up the stairs. Plain radiography and magnetic resonance imaging revealed a massive ossification on the right Achilles tendon extending over 14 cm in length; the ossification was fractured at 5 cm proximal to the calcaneus insertion. Surgical treatment included removal of the ossified tendon and reconstruction with an autologous hamstring tendon graft and gastrocnemius fascia flap. One year after surgery, she was able to walk with little pain or discomfort and to stand on her right tiptoe.
Our novel surgical procedure may be useful in the treatment of fractured ossified Achilles tendons and large Achilles tendon defects.
Aksoy MC, Surat A. Fracture of the ossified Achilles tendon. Acta Orthop Belg. 1998;64(4):418–21. PubMed
Fink RJ, Corn RC. Fracture of an ossified Achilles tendon. Clin Orthop Relat Res. 1982;169:148–50. PubMed
Resnik CS, Foster WC. Achilles tendon ossification and fracture. Can Assoc Radiol J. 1990;41(3):153–4. PubMed
Weseley MS, Barenfeld PA, Eisenstein AL. Fracture of an ossific mass in the Achilles tendon. Bull Hosp Joint Dis. 1976;37(2):159–63. PubMed
Montoli C, Barbieri S, De Pietri M, D’Angelo F. Post-traumatic ossification of the Achilles tendon: description of a case. Chir Organi Mov. 2004;89(1):51–7. PubMed
Hatori M, Matsuda M, Kokubun S. Ossification of Achilles tendon--report of three cases. Arch Orthop Trauma Surg. 2002;122(7):414–7. PubMed
Lotke PA. Ossification of the Achilles tendon. Report of seven cases. J Bone Joint Surg Am. 1970;52(1):157–60. PubMed
Mady F, Vajda A. Bilateral ossification in the Achilles tendon: a case report. Foot Ankle Int. 2000;21(12):1015–8. PubMed
Postacchini F, Di Castro A. Subtotal ossification of the Achilles tendon. Case report. Ital J Orthop Traumatol. 1983;9(4):529–32. PubMed
Maffulli N, Spiezia F, Testa V, Capasso G, Longo UG, Denaro V. Free gracilis tendon graft for reconstruction of chronic tears of the Achilles tendon. J Bone Joint Surg Am. 2012;94(10):906–10. PubMed
- Successful treatment of a fracture of a huge Achilles tendon ossification with autologous hamstring tendon graft and gastrocnemius fascia flap: a case report
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
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