Mediomalleollar Fracture Combined with Achilles Tendon Rupture - A Rare Simultaneous Injury of the Ankle

Abstract

Achilles tendon injuries are rarely associated with osseous lesions. The combination of mediomalleolar fracture with Achilles tendon rupture has been reported as a rare combination injury in alpine skiers, but never before in basketball. This report presents an Achilles tendon rupture in a senior basketball player in combination with a non-displaced fracture of the medial malleolus. The osseous lesion was initially missed, because the tendon injury with all typical clinical and sonographical signs predominated. The routine X-ray examination was only done in the lateral and axial plane, because the examiner did not even think of an ankle fracture, since the description of the sports accident and the clinical signs were so typical for a sole tendon injury. This case report should remind us not to exclude an osseous or ligamentous ankle injury in those cases of acute Achilles tendon rupture especially if postoperative swelling and pain persist for a prolonged period.

Heterotopic ossification of the Achilles tendon following ankle fracture: a case report

“…Achilles tendon rupture can occur in combination with bony ankle injuries. The one injury often delays diagnosis of the other [13–15] and in our case the TA injury was not suspected until about 3 months post‐injury. Many cases of medial malleolar fracture associated with TA rupture have been described [13–16].…”

Lateral Malleolar Fracture with Concurrent Achilles Tendon Rupture: A Case Report and Literature Review

“…Moonen et al attribute diagnostic errors in the Emergency Department with insufficient history-taking and inadequate physical exams [2]. In six of the thirteen cases, either the ankle fracture or Achilles tendon rupture was initially missed [12,13,17,18,20,21]. Four of the six cases missed an Achilles tendon rupture [12][13][14]18].…”

“…e Achilles rupture was found as early as several days [18] and as late as 5 weeks after injury [12]. e remaining two cases missed a medial malleolus fracture, which were both discovered on postoperative X-ray after an Achilles tendon repair [20,21].…”

“…Year Age (years) Gender Cause of injury Type of fracture Martin and ompson [18] 1986 61 M MVA Medial malleolus Barron and Yocum [12] 1993 30 F Gymnastics Medial malleolus Pieper et al [21] 1998…”

“…ese injuries were first perceived in association with alpine skiing [8][9][10]. To date, only thirteen cases of a malleolar fracture occurring simultaneously with an Achilles tendon rupture have been reported [11][12][13][14][15][16][17][18][19][20][21][22][23]. e majority of these injuries involved an isolated medial malleolar fracture [11-18, 20, 20, 21, 23].…”