Spontaneous Achilles tendon rupture in a patient with systemic lupus erythematosus

Spontaneous rupture of the Achilles tendon, which is associated with underlying systemic disease and concurrent oral corticosteroid therapy, is a relatively rare occurrence, with very few cases reported in the English medical literature to date. Patients with this affliction frequently present weeks to months after the rupture occurs because there is no succinct traumatic event. The neglected rupture renders surgical repair more difficult secondary to the retraction of the triceps surae muscle group and the concomitant increase in width of the defect that results. The authors present a case report of a patient with a neglected spontaneous rupture of the Achilles tendon who had been on oral corticosteroid therapy to treat the manifestations of systemic lupus erythematosus. A gastrocnemius recession was performed in a "V to Y" fashion to gain needed lengthening, and an end-to-end anastomosis was also performed. The plantaris tendon was then used to help reinforce the anastomosed site.