[Fractures of ossified Achilles tendon in cerebral palsy. Apropos of a case].
OBJECTIVE
To describe a case of ossification of the Achilles tendon fracture in cerebral palsy.


METHODS
From the detailed case report, review of the literature was performed.


RESULTS
A 49 years old patient who have presented a bilaterally pain syndrome of the ankles. Clinical investigations showed a bilaterally ossification of the Achilles tendon, with a fracture on the left side. The evolution was marked by the occurrence of an other fracture on the right side. Both needed surgery. Just a few cases of such ossification have been reported in literature. This ossification are more often asymptomatic. Complications such fracture are rare, no more than 20 cases have been reported, and only one case in cerebral palsy. The etiologic factors are multiple, including partial or complete rupture or surgery, with a probably great importance of tissular hypoxemia. Men older than 40 years old are more often concerned.


CONCLUSIONS
In the majority of case ossification of the Achilles tendon are painless, and fortuitously discovered. In case of ankle pain syndrome, a research of fracture must be done. Standard X-rays and RMI are the more instructive exams for diagnosis. The treatment of these fractures is more often the surgery. Orthopaedic treatments remain rarely used because of the duration of treatment and of a major risk of recurrence.


CONCLUSIONS
In adult cerebral palsy a standard X-rays of the two Achilles tendon must be realised in case of the occurrence of an ankle pain syndrome especially if an antecedent of Achilles tendon lengthening is known.
Duruflé
A
A
Service de médecine physique et réadaptation, CHU Pontchaillou, 2, rue Henri Le Guilloux, 35033 cedex, Rennes, France
Petrilli
S
S
Gallien
P
P
Cristina
M C
MC
de Crouy
A C
AC
Nicolas
B
B
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D002370:Casts, Surgical; D002547:Cerebral Palsy / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D012422:Rupture, Spontaneous