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Abstract
BackgroundAlthough ankle fractures and an Achilles tendon rupture are relatively frequent in isolation, their association in the same injury is uncommon.Case presentationA 38 year old male tree surgeon fell six meters from a tree, sustaining a subcutaneous rupture of the Achilles tendon and an ipsilateral closed fracture of the medial malleolus. The injuries were diagnosed following clinical examination and imaging.ConclusionThis injury combination is infrequent, and management of the Achilles tendon rupture should take into account the necessity not to secondarily displace the fracture of the medial malleollus.
Highlights
Ankle fractures and an Achilles tendon rupture are relatively frequent in isolation [1,2], their association in the same injury is uncommon [3,4,5,6,7]
A different mechanism of injury may cause the association between the Achilles tendon rupture and an ankle fracture, and this injury can be initially undiagnosed [4,5,6,7]
Only five single case reports describe an ankle fracture combined with an Achilles tendon rupture [3,4,5,6,7]
Summary
Ankle fractures and an Achilles tendon rupture are relatively frequent in isolation [1,2], their association in the same injury is uncommon [3,4,5,6,7]. The patient initially elected to be managed conservatively, and received an above knee plaster of Paris cast with the foot in maximal equines He was kept non-weight bearing for one week, and was referred to our unit, where he was seen after two weeks following the original injury. The medial malleolar fracture was visualised under image intensifier: it was undisplaced, and it was decided to manage it conservatively if still undisplaced by the end of the Achilles tendon repair. The patient was able to walk on tip toes unaided, and had returned to his occupation as a tree surgeon He reported that, following a full day at work, his ankle at times swelled up, though the swelling had resolved by the following morning.
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