Traumatic Rupture of Posterior Tibial Tendon Following Closed Supination-Adduction Ankle Fracture

Krishna, Sathya Vamsi; Pilar, Anoop; Pai, Sudhir N.; Issac, Thomas

doi:10.2106/jbjs.cc.15.00273

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…A PTT rupture associated with a closed tibial fracture is extremely rare. The only 2 cases present in the literature are reported in the articles by Jarvis and Cannada (24) in 2012 (complete lesion of nonrepairable PTT with direct suture associated with an extra-articular fracture of the distal tibia) and by Korovessis et al (25) in 1991 (complete lesion of the PTT and of the flexor digitorum longus tendon associated with extra-articular fracture in the distal third of the tibia).…”

Section: Discussionmentioning

confidence: 99%

Posterior Tibial Tendon Rupture Associated With Anterolateral Distal Tibial and Medial Malleolar Fracture and a Novel Pattern of Tibiofibular Syndesmotic Injury: A Case Report and Review of the Literature

Cataldi

Bacci

Colasanti

et al. 2020

The Journal of Foot and Ankle Surgery

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Section: Discussionmentioning

confidence: 99%

Posterior Tibial Tendon Rupture Associated With Anterolateral Distal Tibial and Medial Malleolar Fracture and a Novel Pattern of Tibiofibular Syndesmotic Injury: A Case Report and Review of the Literature

Cataldi

Bacci

Colasanti

et al. 2020

The Journal of Foot and Ankle Surgery

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“… Traumatic rupture of the posterior tibial tendon occurring during a closed fracture of the ankle: report of a case. [ 22 ] Pan Afr Med J 2015 1 Krishna S.V., Pilar A., Pai S.N., Issac T. Traumatic Rupture of Posterior Tibial Tendon Following Closed Supination-Adduction Ankle Fracture: A Case Report [ 23 ] JBJS Case Connect 2016 1 Formica, M.; Santolini, F.; Alessio-Mazzola, M.; Repetto, I.; Andretta, A.; Stella, M. Closed medial malleolar multifragment fracture with a posterior tibialis tendon rupture: a case report and review of the literature [ 24 ] J Foot Ankle Surg 2016 1 Park, J. Partial rupture of the tibialis posterior tendon associated with a closed medial malleolar fracture (A case report) [ 25 ] Journal of the American Podiatric Medical Association 2016 1 Jasqui-Remba S, Rodriguez-Corlay RE.…”

Section: Tablementioning

confidence: 99%

Rupture of the Tibialis Posterior Tendon With Associated Bimalleolar Ankle Fracture

Magan¹,

Clarke²,

Patel³

et al. 2022

Cureus

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The acute traumatic rupture of the tibialis posterior tendon in association with closed ankle fractures is rare and often under-recognised. If recognised early, outcomes can be excellent. There are 28 known cases in the literature, and we report two further cases associated with bimalleolar ankle fracture dislocation.A 49-year-old presented with valgus deformity at the ankle joint and global tenderness following a work injury as a mechanic. A plain radiograph showed a displaced oblique comminuted fracture of the lateral malleolus with valgus angulation at a syndesmosis, with significant talar shift. The patient underwent open reduction and internal fixation with a seven-hole, one-third tubular plate and screws. A 35-year-old involved in a motorcycle collision with a car presented with swollen left ankle and valgus deformity. Plain radiographs revealed bimalleolar fracture subluxation. Closed reduction was unsuccessful and hence direct medial approach demonstrated a complete rupture of the posterior tendon. The medial malleolus was fixed using lag screws and washers. The tendon was repaired using the modified Kessler technique in both cases.The tibialis posterior plays a significant role in foot and ankle biomechanics due to its broad tendinous insertion. Acute traumatic rupture is rare, as it is protected due to its deep-seated anatomic location within the deep posterior compartment of the leg. Preoperative diagnosis of this injury is challenging and hence this diagnosis is often made intraoperatively. In both cases, there was a retraction of the proximal end beyond incision margins, and this can make tendon rupture difficult to identify intraoperatively as well. Upon identification, assessment of the tendon for degenerative changes was key to deciding upon suitability for primary repair. Despite its rarity, a high index of suspicion should be maintained in fracture dislocation of the ankle joint, especially when the mechanism is known to be pronation-external rotation.

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“…Some studies have reported on the rupture in association with fractures of the medial malleolus. [1][2][3] However, rupture associated with overuse in athletes without any fractures is uncommon. 4,5 The posterior tibial tendon is the largest tendon located in the medial ankle.…”

mentioning

confidence: 99%

An innovative idea of tendon transfer using a gracilis muscle tendon for a posterior tibial tendon rupture: A case report

Tonosu

Fukai

Iwaso

2021

Foot & Ankle Surgery: Techniques, Reports & Cases

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A 42-year-old man, who is the first author of this article, presented with pain and left ankle swelling during a 100km running race. He experienced a sharp pain and popping sensation while running upstairs 15 days after the race. He had previously received a steroid injection around the medial malleolus. Foot inversion was impossible; left toe gait was difficult. Magnetic resonance imaging revealed posterior tibial tendon discontinuity. Although the tendon was found to be discontinued 2-cm proximally to the medial malleolus on surgery for reconstruction, the history of steroid injection could also be responsible for the degeneration of the cut ends. Because of the degeneration, the debrided cut ends showed a gap that could not be directly sutured. Some researchers have reported good tendon transfer results using the flexor digitorum longus, which is situated along the posterior tibial tendon below the medial malleolus. However, loss of function of the flexor digitorum longus can cause a loss of the toe grip power, resulting in an inability to run. Therefore, we adopted the gracilis muscle tendon for tendon transfer. The degenerated cut ends were debrided and reconstructed using a gracilis muscle tendon of the same side. Active range-of-motion exercises were initiated after 3 weeks of below-knee casting. Jogging was permitted at 12 weeks after surgery. He completed a 100-km run at 11 months after surgery. Following one-and-half year, the function was restored. The case warrants publication because this novel tendon transfer technique has not been reported and was effective for a runner.

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Traumatic Rupture of Posterior Tibial Tendon Following Closed Supination-Adduction Ankle Fracture

Abstract: At 1 year of follow-up, the ankle had good union and function of the tendon was restored. Posterior tibial tendon ruptures, although rare, should be suspected in cases of closed ankle fracture, irrespective of the mechanism of injury.

Cited by 3 publications

References 8 publications

Posterior Tibial Tendon Rupture Associated With Anterolateral Distal Tibial and Medial Malleolar Fracture and a Novel Pattern of Tibiofibular Syndesmotic Injury: A Case Report and Review of the Literature

Posterior Tibial Tendon Rupture Associated With Anterolateral Distal Tibial and Medial Malleolar Fracture and a Novel Pattern of Tibiofibular Syndesmotic Injury: A Case Report and Review of the Literature

Rupture of the Tibialis Posterior Tendon With Associated Bimalleolar Ankle Fracture

An innovative idea of tendon transfer using a gracilis muscle tendon for a posterior tibial tendon rupture: A case report

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