Fracture of ossified Achilles tendons: A review of cases

Table 1 Summary of reported cases of the fracture of an ossification of the Achilles tendon

Ref.	Patient		Size	Cause of ossification			Onset of fracture	Treatment	Histology	Follow-up period	Result
	Age	Sex		Previous trauma	Previous surgery	Other factors
Lotke[1] (1970)	61	F	NA	-	+	-	Standing at the sink	Surgery (excision and repairing the tendon)	Mature bone with fibrosis of the marrow space	15 mo	Good
	66	F	NA	-	+	-	Unspecified	Surgery (excision and repairing the tendon)	Mature bone with fibrosis of the marrow space	12 mo	Good
Weseley et al[11] (1976)	58	M	NA	-	+	-	None (spontaneous occurrence)	Nonoperative (immobilization for 6 wk)→Surgery (excision and transferring peroneus brevis)	Mature bone	3.5 mo	Nonoperative: poor; surgery: good
Brotherton and Ball[14] (1979)	71	M	12.5 cm	+	-	-	Walking uneven ground	Surgery (reduction and holding with a figure of eight wire)	Partly woven and partly lamellar bone, forming a cancellous structure	4 mo	NA
Fink and Corn[8] (1982)	42	F	8 cm	-	-	Hypertension, hypothyroidism, obesity	Stumbling on level ground	Surgery (excision and reconstruction with gastrocnemius fascia flap)	NA	4 mo	Good
Kernohan and Hall[17] (1984)	64	M	20 cm	-	-	Manual worker	NA	Surgery (Achilles tendon graft interposition)	NA	5 mo	Good
Suso et al[16] (1988)	20	M	10 cm	-	-	Long-distance runner	Long-distance run	Surgery (excision and direct repair)	Bony trabeculae, separated by fibrous tissue areas	3 mo	Good
Resnik and Foster[10] (1990)	36	M	NA	-	+	-	Stepping in a hole	Nonoperative (immobilization for 6 wk)→Surgery (excision and reconstruction with tensor fascia lata graft)	NA	NA	Nonoperative: poor; surgery: good
Friedman[13] (1991)	41	F	NA	+	-	-	Twisting the ankle	Surgery (excision, unspecified)	NA	NA	Good
Goyal and Vadhva[3] (1997)	84	M	6 cm	-	+	-	Crossing a road	Nonoperative (immobilization for 12 wk)	NA	12 mo	Good
Aksoy and Surat[6] (1998)	44	M	7 cm	+	-	-	Climbing upstairs	Surgery (excision and reconstruction with proximal Achilles tendon flap)	NA	24 mo	Good
Parton et al[5] (1998)	84	M	NA	-	+	-	Hurrying across a crossing	Nonoperative (immobilization for 8 wk)	NA	3 mo	Good
Haddad et al[15] (1999)	67	F	NA	-	-	Hypertension, obesity	Tripping in the garden	Nonoperative (immobilization for 6 wk)	NA	6 mo	Good
Mády and Vajda[2] (2000)	57	M	5 cm (bilateral)	-	-	History of treatment for clubfeet by serial plaster casts	None (spontaneous occurrence)	Surgery (interosseous polydioxanone suture which was reinforced by a local tendon flap)	Mature osseous tissue	84 mo	Good
Battaglia and Chandler[12] (2006)	55	M	NA	+	-	Hypertension, dyslipidemia	Strained while pruning a tree	Nonoperative (immobilization for 12 wk)→Surgery (excision and transferring flexor hallucis longus)	Osseous composition	6 mo	Nonoperative: poor; surgery: good
Ishikura et al[9] (2015)	50	F	14 cm	+	-	-	Climbing upstairs	Surgery (excision and reconstruction with hamstring tendon graft and gastrocnemius fascia flap)	Lamellar bone, which is covered by a number of osteoblasts in some areas	12 mo	Good
Gendera et al[18] (2020)	70	M	12 cm	-	+	-	None (spontaneous occurrence)	Surgery (excision and reconstruction with fascia lata graft)	Broad trabeculae of lamellar bone tissue with vital osteocytes	12 mo	Good

F: Female; M: Male; NA: Not available.