Work

Combined flexor sheath and gastrocnemius aponeurosis flap for the treatment of chronic calcified Achilles tendon rupture: a case report

Year: 2025

Type: article

Abstract: Introduction: The Achilles tendon is the largest tendon in the human body and is prone to rupture when subjected to excessive dorsiflexion trauma of the ankle joint. The primary goal of treatment is to restore limb function; however, there remains considerable debate regarding the optimal management strategy. Patient concerns: We report a patient presenting with chronic Achilles tendon rupture accompanied by calcification of the tendon, which caused persistent pain and functional limitation of the affected limb. Diagnosis: Chronic Achilles tendon rupture with associated tendon calcification, with a tendon defect measuring approximately 6 cm on preoperative imaging, confirmed by clinical examination and imaging evaluation. Interventions: The patient underwent surgical removal of the calcified lesion, followed by reconstruction of the tendon defect using a gastrocnemius aponeurosis flap combined with the Achilles tendon sheath. Outcomes: Postoperative recovery was favorable, and at the 6-month follow-up, the patient achieved satisfactory ankle function with an AOFAS score of 89, a VISA-A score of 91, and an ATRS score of 90. At the 12-month follow-up, functional outcomes remained stable, with an AOFAS score of 95, a VISA-A score of 96, and an ATRS score of 94, confirming sustained recovery and tendon integrity. Conclusion: This case highlights a feasible surgical strategy for chronic Achilles tendon rupture with calcification, which may provide an alternative approach for tendon reconstruction in patients with sheath proliferation and calcified lesions.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2025.1687970

Authors: Shuangqiang Tu, Zhongshan Li, Mengying Xiao, Wensheng Zhu, Yi Shao

Institutions: Hubei University of Chinese Medicine, Hubei University for Nationalities

Language: English

Topic: Tendon Structure and Treatment

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801