Rakchucheep Pattarasak, Kanchanatawan Wichan, Liawrungrueang Wongthawat
Department of Orthopaedics, Thasala Hospital, Thasala district, Nakhon Si Thammarat, Thailand.
Department of Orthopaedics, Bumrungrad International Hospital, Bangkok, Thailand.
Int J Surg Case Rep. 2025 Feb;127:110837. doi: 10.1016/j.ijscr.2025.110837. Epub 2025 Jan 3.
Fractures of ossified Achilles tendons are rare and often associated with repetitive jumping and sprinting in young athletes. Although the exact cause of Achilles tendon ossification is unclear, prior trauma and surgery are common contributing factors.
A 47-year-old male recreational athlete experienced acute pain in his right heel after a football game. Imaging revealed two calcified fragments within the Achilles tendon (proximal: 3.0 × 1.0 × 1.0 cm; distal: 1.5 × 1.0 × 0.5 cm) and a 2.7 cm tendon gap. Surgical debridement and repair were performed due to the extent of the damage. A gastrocnemius fascia turn-down flap was used to address the 7.2 cm tendon defect. The patient adhered to a post-operative rehabilitation program and successfully returned to sports at the four-month follow-up.
Fractures associated with Achilles tendon ossification are uncommon. In active athletes, surgery is typically the preferred treatment, while nonoperative management may be appropriate for older patients. The hybrid repair technique minimizes complications seen in traditional open or percutaneous repairs, such as wound issues, soft tissue infections, and sural nerve injuries.
The hybrid Achilles tendon repair using a gastrocnemius fascia turn-down flap effectively addressed the tendon defect, preserved viable tissue, and enabled a successful return to sports. This approach provides optimal surgical exposure for debridement and avoids complications associated with conventional techniques, making it a preferred treatment option for athletes.
跟腱骨化性骨折罕见，常与年轻运动员反复跳跃和短跑有关。尽管跟腱骨化的确切原因尚不清楚，但既往创伤和手术是常见的促成因素。
一名47岁男性业余运动员在一场足球比赛后右足跟部突发疼痛。影像学检查显示跟腱内有两个钙化碎片（近端：3.0×1.0×1.0厘米；远端：1.5×1.0×0.5厘米）以及一个2.7厘米的肌腱间隙。由于损伤程度，进行了手术清创和修复。采用腓肠肌筋膜翻转皮瓣修复7.2厘米的肌腱缺损。患者遵循术后康复计划，在四个月随访时成功恢复运动。
与跟腱骨化相关的骨折并不常见。对于活跃的运动员，手术通常是首选治疗方法，而非手术治疗可能适用于老年患者。混合修复技术可将传统开放或经皮修复中出现的并发症（如伤口问题、软组织感染和腓肠神经损伤）降至最低。
采用腓肠肌筋膜翻转皮瓣的混合跟腱修复术有效解决了肌腱缺损问题，保留了有活力的组织，并使患者成功恢复运动。该方法为清创提供了最佳手术暴露，避免了与传统技术相关的并发症，使其成为运动员的首选治疗方案。
