title: Successful treatment of a fracture of a huge Achilles tendon ossification with autologous hamstring tendon graft and gastrocnemius fascia flap: a case report.
abstract: BACKGROUND
  Fracture of an ossified Achilles tendon is a rare entity, and no standard treatment has been established. This is the first report to describe the use of a hamstring tendon graft and gastrocnemius fascia flap for Achilles tendon reconstruction.
  
  
  METHODS
  We present the case of a 50-year-old woman with fracture of an ossified Achilles tendon. She presented to our clinic with acute right hindfoot pain, which started suddenly while going up the stairs. Plain radiography and magnetic resonance imaging revealed a massive ossification on the right Achilles tendon extending over 14 cm in length; the ossification was fractured at 5 cm proximal to the calcaneus insertion. Surgical treatment included removal of the ossified tendon and reconstruction with an autologous hamstring tendon graft and gastrocnemius fascia flap. One year after surgery, she was able to walk with little pain or discomfort and to stand on her right tiptoe.
  
  
  CONCLUSIONS
  Our novel surgical procedure may be useful in the treatment of fractured ossified Achilles tendons and large Achilles tendon defects.
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. hishikura817@gmail.com.
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Ishikura
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. n-fukui@idaten.c.u-tokyo.ac.jp.
authors.forename: Naoshi
authors.initials: N
authors.lastname: Fukui
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. h-takamure@sagamihara-hosp.gr.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamure
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. soohashi-tky@umin.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ohashi
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. Iwasawa.M@gmail.com.
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Iwasawa
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. ken_higashiyama1104@yahoo.co.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Takagi
authors.affiliation: Department of Pathology, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. a-horita@sagamihara-hosp.gr.jp.
authors.forename: Ayako
authors.initials: A
authors.lastname: Horita
authors.affiliation: Department of Pathology, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. i-saito@sagamihara-hosp.gr.jp.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Saito
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa Prefecture, 252-0314, Japan. t-mori@sagamihara-hosp.gr.jp.
authors.forename: Toshihito
authors.initials: T
authors.lastname: Mori
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D064592:Autografts / Q000637:transplantation*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation; D016896:Treatment Outcome