Case series-spontaneous chronic Tendo Achilles (TA) rupture and management

Abstract

Although being the strongest tendon in the body, the Achilles tendon is the most frequently ruptured tendon in the lower limb and comprises approximately 20% of all large tendon ruptures. The classical site of rupture is generally 3cm-6cm proximal to its insertion into the calcaneal tuberosity, as there is a hypo vascular zone present in this area of tendon. The most common mechanism usually involves eccentric loading on a dorsiflexed ankle with the knee extended (soleus and gastrocnemius on maximal stretch. A bilateral Tendo Achilles rupture is uncommon, and for it to occur spontaneously is notably rare (1%). Risk factors for spontaneous TA ruptures includes local Corticosteroid use Quinolone antibiotics (ciprofloxacin), previous tendon rupture, Systemic disease (like gout, hypothyroidism, diabetes, tuberculosis, gonorrhea, syphilis, systemic lupus erythematosus, rheumatoid arthritis), Ageing, Increased BMI and Primary Achilles tendon tumors etc. Described are the 10 feet (8 patients), two had bilateral presentation. All came after 3 weeks of injury and treated with debridement, V-Y plasty and FHL (flexor Hallucis Longus) transfer. All patients regained full movements at the ankle and resume their routine activities at 3 months follow-up.