Surgical Repair of Tibialis Anterior Tendon Rupture

Abstract

Closed rupture of the tibialis anterior tendon is a relatively uncommon clinical phenomenon, and review of the literature reveals fewer than 150 reported cases. Even more limited are the reported treatment methods and repair techniques. The disruption of the tendon can occur as a result of traumatic or atraumatic rupture, and is often a missed diagnosis that presents late to the treating surgeon. Depending on the time since injury and condition of the tendon, the rupture may be repaired either primarily or through secondary repair with autogenous interpositional grafting. Regardless of age, sex, medical comorbidities, and diagnostic delay, both techniques have shown promising results. The repair of the ruptured tibialis anterior results in restoration of dorsiflexion strength, ankle cosmesis, and return of function. Depending on the patient's functional deficit and desired level of activity, surgical repair is generally a safe and effective means to restore function, independent of injury acuity.

Minimally Invasive Repair of the Tibialis Anterior Tendon Using a Semitendinosus Autograft

“…Disadvantages are the cost, the low availability in some countries, the risk of infectious disease transmission, and the risk of immune reaction. 2,15,22…”

“…This minimally invasive technique allowed a faster rehabilitation protocol compared with the open techniques. 3,4,17,22 The technique can also be used in cases with retraction of the tendon stumps.…”

Reconstruction of the Tibialis Anterior Tendon With Allograft

“…Primary repair for acute traumatic ruptures should be given consideration, particularly in the young, active patient. 2,9,10 FIGURE 1. Two incisions are marked out over the medial cuneiform and over the anterolateral ankle.…”

“…Compensatory ankle dorsiflexion (albeit weak) occurs as the extensor hallucis longus and the extensor digitorum longus tendons are recruited. 2 There may subsequent gait disturbances, including a steppage gait. 9,10 An MRI of the leg should be obtained routinely to evaluate the status of the muscle in the leg; this study can be used to evaluate the muscle belly for evidence of fibrosis or fatty atrophy.…”

Minimally invasive dual-incision approach: An alternative technique to repair tibialis anterior tendon rupture surgical technique and case report

“…Its occurrence may follow a neglected wound or after closed trauma with plantar flexion and eversion of the foot [1] . Spontaneous ruptures can also occur.…”