A Rare Case of a Fracture of Massive Ossification of the Achilles Tendon

Massive ossification of the Achilles tendon is a relatively rare condition that is usually associated with an old open or closed injury. In addition, it may be caused by infections or metabolic and systemic diseases, such as syphilis, gout, diabetes, Wilson disease, reactive arthritis, or ankylosing spondylitis. The exact pathogenesis of this condition is still not fully understood. A fracture of the ossified Achilles tendon is an even rarer condition that often leads to limb dysfunction, severe local edema, and pain syndrome that resembles an acute Achilles tendon rupture. Two recent reviews found that only a few dozen cases have been reported over the past 100 years, with a variety of treatment options and outcomes. Currently, there is no widely accepted treatment algorithm for patients with this condition. The article presents a surgical treatment option involving complete excision of both ossified fragments and the transposition of the flexor hallucis longus. These results suggest a treatment strategy for patients with this fracture of the ossified Achilles tendon.