Closed Medial Malleolar Multifragment Fracture With a Posterior Tibialis Tendon Rupture: A Case Report and Review of the Literature

Posterior tibialis tendon rupture associated with closed medial malleolus fracture and avulsion of anterior talofibular ligament: A case report and review of the literature

“…PTT rupture without repair can ultimately lead to severe pes planovalgus deformity followed by possible degenerative changes to surrounding joints and pain. 7,8 While to the best of our knowledge, there have been a few case reports describing complete PTT rupture in association with closed ankle fracture, [9][10][11][12][13][14][15][16][17][18][19][20][21] we could not find any reports of a triad of simultaneous closed medial malleolus fracture, ATFL avulsion from the talus, and PTT tendon rupture. So we think that it would be worthy to report this case after obtaining written informed consent for his anonymized information to be published in this article.…”

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

“…Acute injuries in the presence of a healthy tendon are rare events. The presence of some comorbidities (advanced age, diabetes, chronic corticosteroid therapies, rheumatoid arthritis, connective tissue diseases, obesity, or hypertension) can be a risk factor for rupture (4).…”

Posterior Tibialis Tendon Rupture in a Closed Bimalleolar-Equivalent Ankle Fracture: Case Report

“…Another unique aspect of this case is that the distal segment of the ruptured PTT was found to be interposed in the tibiotalar joint, thus blocking anatomic reduction of the ankle joint. While interposition of the PTT between actual fracture fragments has been reported on a number of occasions, 2,7 interposition within the ankle joint itself has very rarely been described, including one case of an open ankle fracture in which the tendon remained intact. 13,14 Table 1 provides a summary of some of the trends seen in these previously described cases.…”

“…[1][2][3][4][5][6][7][8][9][10] As chronic PTT dysfunction can lead to progressive flatfoot deformity, ultimately leading to worsening pain and disability, 1,3,4 early recognition of acute PTT rupture associated with an ankle fracture is of utmost importance. Unfortunately, these injuries may easily go unnoticed secondary to pain limiting a thorough physical examination, [2][3][4][5] inability to identify the tendon rupture on standard plain ankle radiographs, 1 and difficulty identifying retracted ruptured segments intraoperatively. 3,6 For these reasons, surgeons evaluating and treating ankle fractures must maintain a high level of suspicion for PTT injury.…”