Atypical rupture of the Achilles tendon and Haglund's deformity - A case report

We report about an unusual case of a rupture of the Achilles tendon ina pat ient with Haglund's exostosis and long term achillodynia. Intraoperatively, we found a fresh superficial typically located tendon-rupture and an old d eep round shaped rupture which was located directly over the cranial edge o f the calcaneous bone spur. We presume that the sharp edge of Haglund's deformity was the cause of the deep tendon rupture, because the location of the round shaped rupture was n ear the exostosis. The additional superficial rupture, caused by an inadequ ate trauma, induced operative revision consisting of double layer transosse ous suturing. In conclusion early operative resection of Haglund's deformity in cases of repeated irritations of the Achilles tendon should be performed to avoid me chanical damage, including the risk of rupture by the hypomochlion-like eff ect of the exostosis.