Lateral dislocation and incarceration of the posterior tibial tendon through the distal tibiofibular syndesmosis

Trividi, Mitesh; Brown, Elliott; Lese, Andrea B; Katz, Lee D.

doi:10.1007/s00256-014-1859-9

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…the pathway of posterior tibial tendon dislocation in the present case was noticed only during surgery, given that, after the unsuccessful reduction maneuver, no instrumental investigations, such as MRi and/or Ct scans, were performed. After critically analyzing the cases mentioned (13,14), which were characterized by initial unsuccessful attempts to obtain good reduction through surgery that was performed in the absence of information from MRi or Ct scans, and also our own management of the case presented here, we strongly suggest that further investigations, such as MRi and/or Ct scans, should be performed after unsuccessful reduction of an ankle dislocation attempted by means of a closed maneuver under local or general anesthesia. Complications after isolated ankle dislocation are quite common: in particular a 5 to 10° reduction in range of motion is described by several Authors (19,20); post-traumatic osteoarthritis is also frequent (21) with persistent pain or discomfort, especially after increased activity (15), which can necessitate further surgical intervention, like debridement, osteophyte removal, arthroplasty or arthrodesis.…”

Section: J Ointsmentioning

confidence: 86%

“…in 2010, Ermis et al (12) reported this same pattern of posterior tibial tendon dislocation and interpositioning of the tendon between the distal tibia and fibula in a tibiotalar fracture-dislocation. trividi et al (13) reported a posterior tibial ten-…”

Section: Discussionmentioning

confidence: 99%

“…interposition of an anteriorly displaced posterior tibial tendon in a tibiotalar fracture-dislocation was first described by Böhler (7) in 1936; then came reports by Coonrad and Bugg (5) in 1954 and Parrish (8) in 1959; other cases were described in later years by different Authors (9)(10)(11). Further cases of posterior tibial tendon interposition between the distal tibia and fibula in tibiotalar fracture-dislocation have been reported in more recent years, but in these cases the tendon slid posteriorly to the distal tibia, passing through the disrupted tibioperoneal syndesmosis, and preventing reduction of the ankle fracture-dislocation (12)(13)(14). to the Authors' knowledge, despite all these reported cases of ankle fracture-dislocation, the literature contains no reports of irreducible isolated (without fracture) ankle dislocation with posterior tibial tendon displacement, in which the tendon has slid posteriorly to the distal tibia and positioned itself in the tibiofibular interosseous space.…”

Section: Introductionmentioning

confidence: 99%

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Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review

Ortolani

Bevoni

Russo

et al. 2016

Joints

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Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event. Irreducibility of an ankle dislocation, which is rarely encountered, can be due to soft tissue interposition. Dislocation of the posterior tibial tendon can be the cause of an irreducible talar dislocation; interposition of this tendon, found to have slid posteriorly to the distal tibia and then passed through the tibioperoneal syndesmosis, is reported in just a few cases of ankle fracture-dislocation.

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Section: J Ointsmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review

Ortolani

Bevoni

Russo

et al. 2016

Joints

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“…One of the unusual traumatic injuries of the ankle fractures is the interposition of the TPT or flexor digitorum longus tendon which results in irreducible fracture-dislocation in the medial aspect of the ankle. The TPT is an important anatomical structure, which is the most common cause of interposition in irreducible ankle fracture dislocation due to the entrapment of the TPT in the tibiofibular and tibiotalar joints [9][10].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Dislocation of Tibialis Posterior Tendon: A Case Report and Literature Review

Alamri

Aljeaan

Almulhim

et al. 2020

Cureus

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Traumatic dislocation of the tibialis posterior tendon is one of the significantly rare conditions that we might deal with in the emergency department. Approximately only 50 cases have been reported in the literature, and, usually, this condition is misdiagnosed as an ankle sprain in acute settings. It might be neglected in case of improper clinical examination and imaging techniques. We present a case of a 39-year-old patient diagnosed with traumatic dislocation of the tibialis posterior tendon as a result of twisting injury after falling from a 1-meter jump height while playing basketball; the patient was clinically diagnosed primarily as a case of simple ankle sprain in the emergency department and treated conservatively with cold compression. The patient was seen in the clinic after five days with the same complaint, which was medial ankle pain without any improvement. Proper examination and imaging techniques lead us to the accurate diagnoses. The patient was managed surgically and had an excellent outcome postoperatively with a full range of motion of the ankle joint and full weight-bearing without any complaint. Tibialis posterior dislocation should be one of the possible differential diagnoses while dealing with any ankle injury even with unremarkable X-rays. History and physical examination, if conducted correctly, are the keys to making an accurate diagnosis. Therefore, we recommend a proper history-taking and precise physical examination with a high index of suspicion for any possible diagnoses. Early surgical intervention for such cases is the preferable method of treatment to avoid further complications and promote early functional recovery.

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“…The authors concluded that MRI was a valuable tool for diagnosis and surgical planning. 9,12 Prato et al described the value of ultrasound in the acute phase. 13 Gambhir et al reported a late diagnosis of this pathology, with the formation of a bone spur in the medial malleolus at the avulsion site of the flexor retinaculum.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Dislocation of the Posterior Tibial Tendon: A Case Report and Review of the Literature

Masaragian¹,

Luege²,

Perin³

et al. 2019

Journal of Foot and Ankle Surgery (Asia Pacific)

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Background: Traumatic dislocation of the posterior tibial tendon (PTT) is a highly unusual pathology. Diagnosis is based on suspicion and clinical examination. Case description: A 35-year-old male patient suffered a car accident and presented swelling, pain, and instability in the medial side of the right ankle and ecchymosis, on the affected side, associated with deltoid ligament injury. The mechanisms of the injury have not been completely defined but, in most cases, it has been associated with forced dorsiflexion and inversion of the ankle. He was surgically treated 2 weeks after the procedure. Conclusion: Surgical treatment is mandatory. The goal is to relocate the tendon in its normal anatomical position and recreate a competent flexor retinaculum. Clinical significance: We present an unusual case report with good clinical results after surgical treatment and a surgical tip not described before.

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Lateral dislocation and incarceration of the posterior tibial tendon through the distal tibiofibular syndesmosis

Cited by 12 publications

References 21 publications

Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review

Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review

Traumatic Dislocation of Tibialis Posterior Tendon: A Case Report and Literature Review

Traumatic Dislocation of the Posterior Tibial Tendon: A Case Report and Review of the Literature

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