SIMULTANEOUS BILATERAL RUPTURE OF ACHILLES TENDON ASYMPTOMATIC POSTENDINOPATHY
Introduction Rupture of Achilles tendon is the most common among those taking place in the lower extremities, being twice as common in men than in women between 30–50 years old and usually caused while doing sport. There are some risk factors such as age or chronic treatments based on corticosteroids or antibiotics when belonging to Quinolones group.
Spontaneous bilateral rupture of the Achilles tendon is much more infrequent, being almost exceptional in young and healthy patients without known pathological conditions.
Method In relation to a specific clinical case, a medical history review was developed: personal history, diagnosis, treatment and progress.
Result Asthmatic 45 year old male occasionally undergoing medical treatment with inhaled corticosteroids. Previously asymptomatic. Training athletics in the morning and handball in the afternoon. After the first 10 min of the match notices a bilateral acute pain when starting to run, showing ruptures of both Achilles tendons confirmed by MRI scan.
Treatment: surgical open-to-end suture reinforced with inverted taenia (see figure 1 below).
Development: 3 weeks immobilisation without setting foot, 3 weeks Walker boot, partial setting foot and rehabilitation, medical discharge after 6 months without complications.
Discussion Simultaneous and spontaneous rupture of bilateral Achilles tendons in patients without pathological factors is really unusual. 25% of the healthy population above 30 years of age has degenerative structural changes in the Achilles tendon that increase the risk of rupture depending on the patient's activity level.
Both percutaneous and open surgical treatments on young and active patients provide an appropriate alternative. The open surgical treatment allows the possibility of tendon reinforcement techniques and a more complete visualisation of the damage.
The postsurgical rehabilitation management is an important factor for biomechanic tendon recovery alsoallowing the restart of patient's activities as soon as possible.⇓