Porsch M, Hackenbroch M H, König D P
Klinik und Poliklinik für Orthopädie, Universität Köln.
Z Orthop Ihre Grenzgeb. 1998 Nov-Dec;136(6):568-70. doi: 10.1055/s-2008-1045188.
We report about an unusual case of a rupture of the Achilles tendon in a patient with Haglund's exostosis and long term achillodynia. Intraoperatively, we found a fresh superficial typically located tendon-rupture and an old deep round shaped rupture which was located directly over the cranial edge of the calcaneous bone spur. We presume that the sharp edge of Haglund's deformity was the cause of the deep tendon rupture, because the location of the round shaped rupture was near the exostosis. The additional superficial rupture, caused by an inadequate trauma, induced operative revision consisting of double layer transosseous suturing. In conclusion early operative resection of Haglund's deformity in cases of repeated irritations of the Achilles tendon should be performed to avoid mechanical damage, including the risk of rupture by the hypomochlion-like effect of the exostosis.
我们报告了一例罕见病例，一名患有Haglund外生骨疣和长期跟腱痛的患者发生了跟腱断裂。术中，我们发现一处新鲜的浅表性典型肌腱断裂，以及一处陈旧的深部圆形断裂，该断裂直接位于跟骨骨刺的颅侧边缘上方。我们推测Haglund畸形的尖锐边缘是深部肌腱断裂的原因，因为圆形断裂的位置靠近外生骨疣。由不适当创伤导致的额外浅表性断裂促使进行了包括双层经骨缝合的手术翻修。总之，对于反复出现跟腱刺激的病例，应尽早手术切除Haglund畸形，以避免机械损伤，包括外生骨疣类似鹰嘴的作用导致的断裂风险。
