Abstract
Achilles tendon rupture is rarely associated with an avulsion fracture of the calcaneus. We present a 55-year-old male who sustained a rare form of Achilles tendon rupture ; diagonal rupture from the proximal deep layer to the distal surface, accompanied with the avulsed bone fragment. We repaired the injured superficial and deep layers using an anchor system and Tsuge sutures respectively. This surgical technique provided strong repair and allowed earlier rehabilitation. At the six-month follow-up, the patient achieved almost preinjury functional use of the affected limb without any complaints.
The Achilles tendon is contiguous with both the gastrocnemius and soleus muscles. The mechanism of injury in this case was thought to be contraction of the gastrocnemius muscle, comprising a superficial layer, which resulted in avulsion fracture of the calcaneus when the knee was extended. This would have increased the repetitive strain on the soleus muscle, which might then have caused rupture of the deep layer of the Achilles tendon.
