RECONSTRUCTION OF ACHILLES TENDON RERUPTURE IN A NON-PROFESSIONAL SOCCER PLAYER: A CASE REPORT

Introduction: Achilles tendon (AT) rupture is a common injury among athletes involved in high-impact sports and many surgical methods have been described.

Aim of the study: We present a case report of a 32-year-old amateur soccer player who suffered a rerupture of the AT 10 weeks after primary end-to-end AT repair following a bike accident. The operative treatment and subsequent functional outcomes are described in this report.

Materials & Methods: The patient presented to our department two weeks after the bike accident with symptoms consistent with AT rerupture. Radiographs were obtained to exclude other pathologies, and ultrasound confirmed the diagnosis. Surgical intervention was deemed necessary. The patient was positioned prone, and a thigh tourniquet was applied. A longitudinal incision just medial to the AT was made. Intraoperatively, a 2.5 cm gap in the AT was observed. The incision was extended proximally, and the AT was reconstructed using two parallel longitudinal gastrocnemius flaps. The gastrocnemius defects were repaired side to side.

Results: The foot was immobilized in an anterior splint in plantar flexion for 14 days. Gradual weight-bearing in a boot started at three weeks and full weight-bearing at three months. At five months, the patient demonstrated good functional outcomes and participated in low impact activities. He successfully returned to sports at eight months.

Conclusion: The reconstruction technique employed, utilizing parallel longitudinal gastrocnemius flaps, yielded positive functional outcomes, enabling the patient's return to sports activities. The presented technique represents a viable alternative for AT rerupture reconstruction. It provides good functional outcomes and can be considered alongside other methods such as flexor hallucis longus transfer, V-Y advancement of the gastrocnemius, or AT reconstruction with semitendinosus autograft or allograft, depending on the size of the defect. However, the extensive surgical approach necessitates vigilance regarding wound healing complications.