Chronic ruptured Achilles tendon with intact plantaris

Case contributed by Chris O'Donnell
Diagnosis certain


Ruptured L Achilles tendon 6 months ago and right Achilles many years ago. Treated non-operatively. Ongoing weakness of plantar flexion and local swelling on the left. ? healed

Patient Data

Age: 45
Gender: Male

Large full thickness (incomplete) defect in the proximal Achilles tendon containing fluid with a longitudinal linear structure traversing the defect inserting on the medial aspect of the calcaneus indicative of the plantaris tendon.  Note thickened intact Achilles tendon fibers laterally.

Case Discussion

Achilles tendons tears are treated both surgically and conservatively in a dorsiflexed foot position to assist in apposition of the tendon ends.  In this case, conservative treatment has failed with a resultant large residual defect and foot weakness.  Note that despite a very substantial injury to the Achilles, the tiny plantaris tendon remains in continuity.

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