Bilateral Achilles tendon rupture: a case report

Bilateral Acute Achilles Tendon Rupture Can Be Effectively Treated Non-operatively

Acute rupture of the Achilles tendon (AT) is a common but debilitating injury that requires immediate diagnosis and effective management. Spontaneous bilateral AT rupture is rare; however, it can lead to severe disability for a significant period. This case report presents a 76-year-old patient who suffered a bilateral AT rupture while engaging in a non-strenuous activity. Upon confirmation of the diagnosis by physical examination and radiologic evaluation, conservative treatment was decided due to the presence of numerous comorbidities. A personalized rehabilitation protocol was implemented, allowing weight-bearing activities using Achilles boots at six weeks. Healing of both ATs was confirmed by an MRI at three months. Our case shows that non-operative treatment of these injuries can result in exceptionally favorable outcomes and should not be disregarded. However, thorough patient compliance and surveillance are prerequisites.

A case of spontaneous bilateral Achilles tendon rupture: surgical treatment with early mobilization

BACKGROUND

Tendo-Achilles (TA) rupture is the most commonly ruptured tendon in the lower limb despite being one of the toughest tendons. Typically, it occurs unilaterally in middle-aged individuals who participate in strenuous activity. Spontaneous ruptures without any risk factors predisposing the patient is uncommon and for it to occur bilaterally is very rare.

OBJECTIVES

To raise awareness of the potential for TA ruptures to occur bilaterally and thus the importance of assessing the TA contralateral to a seemingly unilateral rupture. This is particularly the case in patients with risk factors, which are reviewed in this report. A summary of the main treatment options is also described.

CASE REPORT

We report a case of spontaneous, bilateral TA rupture in a 40-year-old man with no identifiable risk factors. It occurred following a heavy impact during a sports activity and although painful, was able to mobilize slowly. After a clinical examination confirmed the diagnosis, the patient underwent early bilateral surgical repair and subsequently embarked on a comprehensive rehabilitation program with a good functional outcome at follow-up. His return to premorbid work and social life was uneventful.

CONCLUSIONS

Bilateral TA ruptures are rare but increased awareness would help avoid a tear or rupture of the contralateral side being missed. All patients presenting clinically with any TA rupture should have risk factors reviewed. Surgical repair must be accompanied by a comprehensive rehabilitation program for adequate recovery and return of function.

Idiopathic simultaneous bilateral Achilles tendon rupture

Cases of simultaneous bilateral rupture of the Achilles tendon are extremely rare and usually associated with other pathology. Our patient was a healthy, previously asymptomatic 33-year-old woman with no obvious predisposing factors other than a remote history of involvement in gymnastics. The patient opted for surgical management which resulted in a favourable outcome.