Open Ankle Dislocation Without Fractures With Tibialis Posterior Tendon Interposition Through the Interosseous Space

Bae, Bryan J.Y.; Baker, Joseph F.; Orec, Robert J.; Hadlow, Alastair T.

doi:10.1053/j.jfas.2017.04.018

Cited by 5 publications

(8 citation statements)

References 5 publications

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“…Several studies have reported tibialis posterior tendon interposition with dislocation fractures [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] . In the literature, the average age of patients is 21.5 years (range, 13–45 years).…”

Section: Discussionmentioning

confidence: 99%

“…There are two patterns of tibialis posterior tendon dislocation within tibio-fibular space interposition: the tendon runs anterior to the tibia [6] , [7] and within the talocrural joint [2] , [3] , [4] , [5] , [8] , [9] . Volume-rendering views of CT scans can reveal anterior tibialis posterior tendon dislocation [6] , [7] ; however, the dislocation within talocrural joint are difficult to diagnose and have rarely been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Tibialis posterior tendon interposition following irreducible fracture-dislocation of the ankle is rarely reported [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] ; in most cases, the interposition reduced immediately in <6 months. However, no reduction of tibialis posterior tendon interposition even after a year has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review

Hikichi

Matsubara

Shimokawa

et al. 2022

Trauma Case Reports

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We report a case of equinus foot deformity and malunion of the medial malleolus caused due to tibialis posterior tendon interposition following irreducible fracture-dislocation of the ankle. A 19-year-old female patient was referred to our hospital with the chief complaint of persistent ankle pain and restricted ankle dorsiflexion. Her medical history revealed a fracture-dislocation of the ankle in the left tibia at the age of 18 years. Open reduction and osteosynthesis were performed 3 days after injury. One year after the operation, ankle pain and restricted ankle dorsiflexion persisted. Computed tomography revealed malunion of the medial malleolus and an irregular groove in the interosseous space between the tibia and fibula. Magnetic resonance imaging revealed entrapment of the tibialis posterior tendon within the posterior talocrural joint and syndesmosis, preventing posterior translation of the talus back to its normal position and forcing the fibula to remain anteriorly displaced in the syndesmosis. We performed several procedures, including reduction of the tibialis posterior tendon interposition and dislocation of the talus, augmentation of the tibio-fibular ligament, and recession of the gastrocnemius. Finally, the patient achieved plantigrade stance and improvement in her Japanese Society for Surgery of the foot ankle/hindfoot scale from 42 to 82 points, after a 2-year follow-up. Anterior impingement caused the patient to experience severe osteoarthritis. Early reduction of the tibialis posterior tendon should have been achieved for this case. Age, fracture type, and severely restricted range of motion should raise suspicion of this adverse event. Level of Clinical Evidence: 4.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review

Hikichi

Matsubara

Shimokawa

et al. 2022

Trauma Case Reports

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“…Bae et al suggested that the signs of tendon entrapment or dislocation can be diagnosed and excluded by routine CT scan examination, so as to guide the correct steps for treatment. [ 6 ] Ballard et al has retrospectively analyzed the radiography data of 398 patients with ankle and hindfoot fractures, and evaluated the incidence of related tendon entrapment and dislocation. In Ballard study, 64 cases (16.1%) with tendon entrapment or dislocation were diagnosed, and the total incidence of tendon entrapment reached up to 8.3%, with tendon dislocation to 8.5%.…”

Section: Discussionmentioning

confidence: 99%

Open total dislocation of ankle joint without fractures

Chi

Gao

et al. 2021

Medicine

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Rationale: Open total dislocation of ankle joint is rare and often caused by high-energy injury. The present study describes a patient with open total lateral dislocation of ankle joint without fractures and obtained a satisfactory clinical result following early debridement and irrigation, one-stage repairment of ligaments, and plaster external fixation. Patient concerns: The patient, a 45-year-old male, complained of right foot pain with bleeding and limited motion. Physical examination showed a 15-cm open wound at the medial ankle region, with soft tissues impaired and ankle bones exposed. The 3 dimensional reconstruction computed tomography (CT) examination showed an open total dislocation of ankle joint without concomitant fractures. Diagnoses: open total lateral dislocation of ankle joint without fractures Interventions: Early modern wound care including thorough debridement and irrigation on the wound was performed to remove contaminated soft tissues. Subsequently, the dislocated ankle joint was reduced by hand and the medial and lateral collateral ligaments were repaired using wire anchors. Outcomes: The medial wound healed at 2 weeks after surgery, and several common complications such as infection and skin necrosis did not occur. The last follow-up showed a good range of metatarsal flexion and extension of the injured foot, and obvious signs of traumatic arthritis were not observed. According to Kaikkonen ankle function score, the patient was assessed with 90 points. Lessons: For open total dislocation of ankle joint, early treatment should focus on debridement and irrigation, reduction and fixation of the dislocated ankle, protection of the weak soft tissues, and stable external fixation to promote wound healing and reduce the incidence of related complications.

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“…Eine Reposition sollte möglichst zeitnah durchgeführt werden, dabei sind Kenntnisse über Dislokationsrichtung und Pathomechanismus entscheidend. Stellt sich die Reposition als übermäßig schwierig dar, so sollte an eine Sehneninterposition gedacht werden [16]. Aus Sicht der Autoren muss die Frage nach der Rekonstruktion der betroffenen Bandstrukturen individuell beantwortet werden.…”

Section: Diskussionunclassified

Open Ankle Dislocation without Associated Malleolar Fracture on a Trampoline. A Case Report

et al. 2019

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Dislocation of the ankle without fracture is very uncommon. There are only few reports in the international literature. Up to now approximately 80 cases are published. The risk of hyperflexion and -inversion of the ankle seems high on a trampoline. A multiple of the jumperʼs body-weight projects delayed on the upper ankle joint while dipping in the trampoline-sheet. Reduction should be performed as fast as possible to ensure a good clinical outcome. Imaging via MRI and CT scan allows a detailed evaluation of the injury severity. The decision for further treatment should be based on the findings in the MRI and CT scans. Reconstructing the medial and lateral capsular ligaments can be necessary. With a consequent treatment algorithm a good functional outcome can be achieved. In our case we documented a post-traumatic AOFAS score of 87/100 six months after the injury without an instability of the upper or lower ankle joint. Propioreceptive reflex and pronator training as well as taping seem to be useful before and during trampoline sports.

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Open Ankle Dislocation Without Fractures With Tibialis Posterior Tendon Interposition Through the Interosseous Space

Cited by 5 publications

References 5 publications

Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review

Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review

Open total dislocation of ankle joint without fractures

Open Ankle Dislocation without Associated Malleolar Fracture on a Trampoline. A Case Report

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