Fracture of the Neck of the Talus Associated With a Trimalleolar Ankle Fracture and Ruptured Tibialis Posterior Tendon

Burton, Paul D.; Page, Benedict J.

doi:10.1097/00005131-199206000-00021

Cited by 15 publications

(7 citation statements)

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“…18 In the literature, we found only limited articles that reported complete posterior tibialis rupture associated with a closed ankle fracture. [1][2][3]5,7,8,11,12,16,18,[20][21][22][23][26][27][28][29][30][31][32][33][34][35] Giblin et al 31 first described the PTT rupture associated with a closed medial malleolar fracture in 1980. Most of the articles reported complete rupture of the PTT with medial malleolus involvement.…”

Section: Discussionmentioning

confidence: 99%

Posterior tibialis tendon rupture concomitant with a closed medial malleolar fracture: A case report and literature review

Talebi¹,

Sheibani²,

Ghaffari³

et al. 2021

Journal of Orthopaedics, Trauma and Rehabilitation

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Traumatic rupture of the posterior tibialis tendon is an extremely infrequent condition, which mostly occurred due to a traumatic mechanism of pronation and external rotation, less commonly in direct trauma on the medial side of the ankle. This lesion is overlooked preoperatively most of the time because of the limitation of physical examination owing to acute pain and swelling secondary to a medial malleolar fracture. Early diagnosis and treatment of this injury are very important to prevent the complications like acquired flatfoot deformity. Few cases have been described in the literature for the posterior tibialis tendon rupture associated with a closed ankle fracture. Here we report an acute rupture of the posterior tibialis tendon associated with a closed medial malleolar fracture after a high-energy trauma in a healthy 33-year-old man. We fixed the medial malleolar fracture with two screws and repaired the tendon with a direct end-to-end suture. We hope that our study can be helpful for other colleagues to consider this lesion in similar circumstances.

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Section: Discussionmentioning

confidence: 99%

Posterior tibialis tendon rupture concomitant with a closed medial malleolar fracture: A case report and literature review

Talebi¹,

Sheibani²,

Ghaffari³

et al. 2021

Journal of Orthopaedics, Trauma and Rehabilitation

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“…Dentre as lesões não ósseas associadas às injúrias traumáticas do pé e tornozelo, foram encontrados relatos, na literatura mundial, referentes à ruptura do tendão tibial posterior (12) , lesão do tendão calcâneo (13) , do ligamento talofibular anterior e tendão fibular longo (14) , aneurisma (15) e trombose (16) da artéria tibial posterior, porém sem documentação extensa de frequência de lesões arteriais ou de suas repercussões no desfecho dos casos.…”

Section: Discussionunclassified

Association between vascular injury identified via echo-Doppler examination and talus fracture-dislocation

et al. 2018

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Objective: To investigate the association between talus fracture-dislocation and the occurrence of pre-operative vascular injuries identified via echo-colour Doppler examination of the lower limbs and to assess whether these injuries directly affect talar necrosis. Methods: Retrospective study with data collection on 26 patients with a diagnosis of talus fracture-dislocation who were evaluated by pre-operative arterial and venous echo-colour Doppler from 2004 to 2015. Results: The sample included 26 patients (26 feet), ranging in age from 16 to 62 years, with a mean follow-up time of 2 years and 9 months. A total of six (23.07%) changes were diagnosed via echo-colour Doppler, of which five (83.33%) were due to arterial injury of the ‘segmental occlusion of the posterior tibial artery’ type and one (16.67%) was due to venous injury of the ‘recent deep venous thrombosis of the popliteal-distal segment’ type, with no arterial injury. No significant association was found between the vascular injuries diagnosed by Doppler and progression to necrosis. Conclusion: A significant portion of the patients with talus fracture-dislocation presented with vascular injury diagnosed by echo-colour Doppler, although no association was found between vascular injury and outcomes of osteonecrosis. Level of Evidence IV; Diagnostic studies.

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“…It may be caused rather by chronic degenerative processes 9,13,20 than by an acute trauma. 3,30 This, in turn, may result in a progressive loss of muscular function, combined with atrophy, fatty degeneration, and probably some fibrosis. Therefore, not only the condition of the posterior tibial tendon, but also that of its muscle might be often poor at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

Recovery of the Posterior Tibial Muscle After Late Reconstruction Following Tendon Rupture

et al. 2004

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The purpose of this study was to determine the recovery potential of the posterior tibial muscle after late reconstruction following tendon rupture in stage II of posterior tibial tendon dysfunction. Fourteen patients (18 women, 6 men; mean age 59.8 years) were investigated 47 months (range, 24-76 months) after surgical reconstruction of a completely ruptured posterior tibial tendon (end-to-end anastomosis, side-to-side augmentation with the flexor digitorum longus tendon) in combination with a distal calcaneal osteotomy with a tricortical iliac crest bone graft for lengthening of the lateral column. At follow-up, clinical and radiological investigations were performed, including strength measurement and qualitative and quantitative MRI investigation. The overall clinical results were graded excellent in 12 patients, good in one, fair in one, and poor in none. The average ankle-hindfoot score (American Orthopaedic Foot and Ankle Society) improved from preoperatively 49.1 (range, 32-60) to 93.1 (range, 76-100) at follow-up. The functional result correlated with patient's satisfaction and sports activities (p <.05). All patients showed a significant strength of the posterior tibial muscle on the affected side, but it was smaller than on non-affected side (p <.05). The mean posterior tibial muscle strength was 75.1 N on affected and 104.9 N on nonaffected side, corresponding to a ratio of 0.73 between the two legs. The mean area of the posterior tibial muscle was 1.89 cm(2) on affected side, and 3.48 cm(2) on nonaffected side, corresponding to a ratio of 0.55 between the two legs. While fatty degeneration for the posterior tibial muscle was found in all patients, it was found to decrease with increasing strength of the posterior tibial muscle (p <.05) and muscular size (p <.05). On postoperative MRI, the posterior tibial tendon could be found to be intact in all patients. The recovery potential of the posterior tibial muscle was shown to be significant even after delayed repair of its ruptured tendon. A ruptured and/or diseased posterior tibial tendon should not be transected as it excludes any recovery possibilities of the posterior tibial muscle.

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Fracture of the Neck of the Talus Associated With a Trimalleolar Ankle Fracture and Ruptured Tibialis Posterior Tendon

Cited by 15 publications

References 0 publications

Posterior tibialis tendon rupture concomitant with a closed medial malleolar fracture: A case report and literature review

Posterior tibialis tendon rupture concomitant with a closed medial malleolar fracture: A case report and literature review

Association between vascular injury identified via echo-Doppler examination and talus fracture-dislocation

Recovery of the Posterior Tibial Muscle After Late Reconstruction Following Tendon Rupture

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