Tendoachillis avulsion in osteomalacia

Area of Science:

• Orthopedics
• Endocrinology
• Pediatrics

Background:

• Generalized body pain in adolescents can indicate underlying metabolic bone disease.
• Tendoachillis avulsion, typically seen in older adults, is rare in young individuals and may suggest compromised bone health.

Observation:

• A 16-year-old female presented with widespread body pain and spontaneous tendoachillis avulsion after minor trauma.
• Surgical repair of the avulsion was successful, but intraoperative findings revealed soft bone quality.
• Postoperative investigations identified severe osteomalacia.

Findings:

• Osteomalacia, a condition of soft bones due to vitamin D deficiency, was diagnosed.
• The patient's symptoms and bone quality significantly improved following vitamin D supplementation.
• Surgical challenges included the soft bone consistency, difficulty in tendon reattachment, and prolonged rehabilitation.

Implications:

• Vitamin D deficiency should be considered in young females experiencing generalized body pain, especially when associated with tendon avulsions or bone-related injuries.
• Early diagnosis and management of osteomalacia are crucial for preventing severe musculoskeletal complications and ensuring optimal recovery.
• This case underscores the necessity of vitamin D level assessment in adolescent females with unexplained pain at sites of high mechanical stress.