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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Kazan medical journal</journal-id><journal-title-group><journal-title xml:lang="en">Kazan medical journal</journal-title><trans-title-group xml:lang="ru"><trans-title>Казанский медицинский журнал</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0368-4814</issn><issn publication-format="electronic">2587-9359</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">641648</article-id><article-id pub-id-type="doi">10.17816/KMJ641648</article-id><article-id pub-id-type="edn">GJEELC</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Clinical experiences</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обмен клиническим опытом</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">A Rare Case of a Fracture of Massive Ossification of the Achilles Tendon</article-title><trans-title-group xml:lang="ru"><trans-title>Редкий клинический случай перелома массивного оссификата ахиллова сухожилия</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>一例罕见的大跟腱骨化骨折临床病例</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2762-816X</contrib-id><contrib-id contrib-id-type="spin">5278-1271</contrib-id><name-alternatives><name xml:lang="en"><surname>Konovalchuk</surname><given-names>Nikita S.</given-names></name><name xml:lang="ru"><surname>Коновальчук</surname><given-names>Никита Сергеевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), orthopedic surgeon, depart. No. 15</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, врач — травматолог-ортопед, отделение № 15</p></bio><email>konovalchuk91@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9948-9015</contrib-id><contrib-id contrib-id-type="spin">5268-5290</contrib-id><name-alternatives><name xml:lang="en"><surname>Sorokin</surname><given-names>Evgenii P.</given-names></name><name xml:lang="ru"><surname>Сорокин</surname><given-names>Евгений Петрович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), orthopedic surgeon, head, depart. No. 15</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, врач — травматолог-ортопед, заведующий, отделение № 15</p></bio><email>epsorokin@rniito.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3198-9985</contrib-id><contrib-id contrib-id-type="spin">2949-5308</contrib-id><name-alternatives><name xml:lang="en"><surname>Pashkova</surname><given-names>Ekaterina A.</given-names></name><name xml:lang="ru"><surname>Пашкова</surname><given-names>Екатерина Анатольевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), orthopedic surgeon, depart. No. 15</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, врач — травматолог-ортопед, отделение № 15</p></bio><email>eapashkova@rniito.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Vreden National Medical Center for Traumatology and Orthopedics</institution></aff><aff><institution xml:lang="ru">Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-05-30" publication-format="electronic"><day>30</day><month>05</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-06-15" publication-format="electronic"><day>15</day><month>06</month><year>2025</year></pub-date><volume>106</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>479</fpage><lpage>484</lpage><history><date date-type="received" iso-8601-date="2024-11-06"><day>06</day><month>11</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2025-02-12"><day>12</day><month>02</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2025,</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2028-06-15"/></permissions><self-uri xlink:href="https://kazanmedjournal.ru/kazanmedj/article/view/641648">https://kazanmedjournal.ru/kazanmedj/article/view/641648</self-uri><abstract xml:lang="en"><p>Massive ossification of the Achilles tendon is a relatively rare condition that is usually associated with an old open or closed injury. In addition, it may be caused by infections or metabolic and systemic diseases, such as syphilis, gout, diabetes, Wilson disease, reactive arthritis, or ankylosing spondylitis. The exact pathogenesis of this condition is still not fully understood. A fracture of the ossified Achilles tendon is an even rarer condition that often leads to limb dysfunction, severe local edema, and pain syndrome that resembles an acute Achilles tendon rupture. Two recent reviews found that only a few dozen cases have been reported over the past 100 years, with a variety of treatment options and outcomes. Currently, there is no widely accepted treatment algorithm for patients with this condition. The article presents a surgical treatment option involving complete excision of both ossified fragments and the transposition of the flexor hallucis longus. These results suggest a treatment strategy for patients with this fracture of the ossified Achilles tendon.</p></abstract><trans-abstract xml:lang="ru"><p>Возникновение массивных оссификатов в ахилловом сухожилии — достаточно редкое явление, которое принято связывать с предшествующей открытой или закрытой травмой, обычно достаточно давней. Кроме того, причина может быть обусловлена инфекционными, метаболическими и системными заболеваниями, такими как: сифилис, подагра, диабет, болезнь Вилсона, синдром Рейтера и анкилозирующий спондилит. Точный патогенез данного заболевания до сих пор до конца не изучен. Перелом такого оссификата считается ещё более редкой патологией, которая, в свою очередь, часто приводит к нарушению функции конечности, выраженному локальному отёку и болевому синдрому, клинически напоминающему острый разрыв ахиллова сухожилия. Согласно двум недавним обзорам литературы, за последние 100 лет задокументированы лишь десятки подобных случаев с различными вариантами лечения и результатами. На данный момент в мире не существует общепринятого алгоритма лечения пациентов с данной патологией. В статье продемонстрирован один из вариантов оперативного лечения, состоящий из полного иссечения обоих фрагментов оссификата и выполнения транспозиции сухожилия длинного сгибателя I пальца стопы. Полученный результат позволяет рекомендовать использованную тактику для лечения пациентов с данной патологией.</p></trans-abstract><trans-abstract xml:lang="zh"><p>跟腱中大规模骨化的发生是一种相当罕见的现象，通常与先前的开放性或闭合性损伤有关，通常是相当长一段时间之前。此外，病因可能是由于感染性，代谢性和全身性疾病，如梅毒，痛风，糖尿病，威尔逊氏病，赖特氏综合征和强直性脊柱炎。这种疾病的确切发病机制仍未完全了解。这种骨化的骨折被认为是一种更罕见的病理，反过来，往往导致肢体功能受损，明显的局部水肿和疼痛综合征，临床上类似于跟腱的急性破裂。根据最近的两篇文献综述，在过去的100年中，只有几十个具有不同治疗方案和结果的类似病例被记录在案。目前，世界上还没有普遍接受的治疗这种病理患者的算法。本文演示了一种手术治疗方案，包括骨化碎片的完全切除和第一脚趾长屈肌腱的转位。获得的结果使我们能够推荐用于治疗这种病理患者的策略。</p></trans-abstract><kwd-group xml:lang="en"><kwd>massive ossification</kwd><kwd>Achilles tendon</kwd><kwd>tendon transposition</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>массивный оссификат</kwd><kwd>ахиллово сухожилие</kwd><kwd>транспозиция сухожилия</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>大骨化</kwd><kwd>跟腱</kwd><kwd>肌腱换位</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Hatori M, Matsuda M, Kokubun S. 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