Ipsilateral achilles tendon rupture and medial malleolar fracture in an elderly patient: A rare case report and review

Abstract

A 77-year-old male presented with a left Achilles tendon rupture and an ipsilateral medial malleolus fracture sustained after a misstep. This combination of injuries is rare, with only eight cases previously reported in the literature. Magnetic resonance imaging (MRI) confirmed a complete rupture of the Achilles tendon approximately 7 cm proximal to its calcaneal insertion. Intraoperative evaluation using an Arthroscopy procedure demonstrated no intra-articular step-off of the medial malleolus fracture. A positive Thompson test further confirmed the tendon rupture. The medial malleolus was stabilized with two 4 × 40 mm Arthrex cannulated screws, and the Achilles tendon was repaired using the Percutaneous Achilles Repair System.