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Achilles, peroneus longus and brevis ruptures with lateral malleolus fracture: A case report and review of literature

Year: 2026
Type: article
Study design: Case Report
Abstract: BACKGROUND: Ankle fractures are well-documented in snow sports, but concomitant Achilles tendon and peroneal tendon ruptures are rare. This case report presents a previously unreported combination of Achilles tendon rupture, peroneal tendon rupture, and fibular fracture in a snowboarder, highlighting the complex nature of diagnosis, management, and rehabilitation. CASE SUMMARY: A 50-year-old male snowboarder presented with severe right ankle pain following a high speed tumbling crash. Initial evaluation revealed an Achilles tendon rupture and a non-displaced distal lateral malleolus fracture. Subsequent magnetic resonance imaging confirmed complete tears of the Achilles tendon and both peroneus longus and brevis tendons, along with a Weber A lateral malleolus fracture. Surgical intervention included a 4-suture core Kraków repair of the Achilles tendon with calcaneal docking, open reduction and internal fixation of the distal fibula fracture, and primary repair of both peroneal tendons. Post-operatively, a modified Achilles repair protocol was implemented. At 16 weeks post-surgery, radiographs showed a well-healed fibular fracture, and physical examination confirmed intact Achilles and peroneal tendon repairs. By 6 months, the patient had regained full daily and work activities, including recreational pursuits. CONCLUSION: This case underscores the importance of maintaining a high index of suspicion for concomitant injuries in high-energy ankle trauma during snow sports. Timely advanced imaging and a comprehensive surgical approach are crucial for optimal outcomes in such complex cases.
DOI: 10.5312/wjo.v17.i1.112222
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W7119520460
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Cites: 35
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