title: [Bilateral rupture of the Achilles tendon--an unusual occurrence].
abstract: We present the clinical case of a sixty-four-year-old man with bilateral spontaneous rupture of the Achilles tendon having a multiple disseminated oesophagus carcinoma. After immobilisation due to metastases of the 2nd lumbar vertebra, there was a spontaneous, painless rupture of the Achilles tendon while the patient was mobilised wearing a Hohmann spine brace. Afterwards we carried out a thorough case history with the help of clinical examination, sonographic and magnetic resonance imaging. The bilateral rupture has been treated conservatively with the Adipromed Shoe. With regard to the 2nd lumbar vertebra fracture and metastases, a Hohmann spine brace was given to the patient. Because of the described circumstances, no surgery had been carried out. Furthermore, the patient experienced much more independence and an improved quality of life in his last couple of months. Surgery would have not been recommended and could have caused the complete immobilisation and loss of patient's quality of life. With this case report we would like to point out the consequences of an unwise therapeutic decision to a patient who only has a few more months to live. This case report is discussed with regard to the possible aetiopathology and the current literature.
authors.affiliation: Klinik und Poliklinik für Orthopädie, Universität zu Köln. Nils.Schikora@gmx.de
authors.forename: N
authors.initials: N
authors.lastname: Schikora
authors.forename: K-S
authors.initials: KS
authors.lastname: Delank
authors.forename: J
authors.initials: J
authors.lastname: Gärtner
authors.forename: P
authors.initials: P
authors.lastname: Eysel
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging* / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D035583:Rare Diseases; D012421:Rupture / Q000175:diagnosis / Q000628:therapy; D012720:Severity of Illness Index; D012775:Shoes; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000534:rehabilitation*; D016896:Treatment Outcome