Concomitant medial malleolus fractures in acute Achilles tendon rupture: a retrospective study of 228 patients

Medial malleolus fractures associated with Achilles tendon ruptures have been frequently reported in case reports; however, their frequency has not been well characterized.This study aimed to investigate the observed proportion of such fractures.Among 277 patients diagnosed with acute Achilles tendon ruptures between 2021 and 2024, those who underwent radiography in at least two views or magnetic resonance imaging were included.The presence of medial malleolus fractures among these patients was retrospectively investigated.Clinical outcomes of patients with fractures were also reviewed.A total of 228 patients were included (177 males, 51 females; mean age, 42.4 ± 13.2 years), of which 2 (0.9%) had medial malleolus fractures.The first case involved a 68-year-old male patient with a nondisplaced medial malleolus fracture who received conservative treatment along with the Achilles tendon rupture and achieved bone union in 6 months.The second case involved a 39-year-old male patient with a nondisplaced medial malleolus fracture.The Achilles tendon rupture was treated surgically, whereas the medial malleolus fracture was treated conservatively, achieving bone union in 4 months postoperatively.Two cases (0.9%) of nondisplaced medial malleolus fractures were associated with Achilles tendon ruptures.