Soft tissue repair for tibialis anterior tendon ruptures using plate and screw fixation technique in combination with anterolateral thigh flaps transplantation

Abstract

BackgroundTraumatic ruptures of the tibialis anterior tendon are rare but can cause substantial functional deficiencies. This study aimed to evaluate the feasibility of a surgery for soft tissue repair of traumatic rupture of the tibialis anterior tendon by using a plate and screw fixation repair in combination with the free anterolateral thigh flaps transplantation.MethodsEight consecutive patients with anterior tibialis tendon ruptures who visited orthopedics departments from February 2008 to February 2012 were included in our study. The ruptured tendon was reconstructed with plate and screw fixation technique, and the tissue defects were repaired with anterolateral thigh free flaps. The complications and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were evaluated. Postoperative manual strength test was performed using a 0 to 5 scale.ResultsAll flaps survived without any complications. The average preoperative and postoperative AOFAS ankle-hindfoot scores of the patients were 51 and 95, respectively. Good ankle dorsiflexion strength against strong resistance was observed in eight ankles postoperatively (manual strength of one patient was 4/5, the others were 5/5), and a substantial improvement in strength was noted compared with the preoperative examination.ConclusionSoft tissue repair for tibialis anterior tendon rupture using plate and screw fixation technique in combination with anterolateral thigh flaps transplantation is a feasible technique and yield satisfactory results.

Composite Cutaneous Anterolateral Thigh Flap with Rolled Fascia Lata for Tibialis Anterior Tendon Reconstruction

“…Other groups have commented on the utility of ALT flap for coverage in TAT repair combined with plate and screw reconstruction of the tendon. 7 In our case, we noted an opportunity for simultaneous reconstruction and coverage via native tissue with hopes of avoiding the risks of hardware. As evidenced by function 8 months after operation, the combined coverage and TAT reconstruction with the ALT yields excellent dorsiflexion and inversion strength.…”

Astragaloside IV improves angiogenesis under hypoxic conditions by enhancing hypoxia‑inducible factor‑1α SUMOylation

“…In orthopedics and plastic surgery, flap transplantation is a common method for repairing large-scale skin wounds ( 26 , 27 ). Factors affecting the quality of flap survival include arterial blood supply ( 28 ), venous return ( 29 ), tissue damage ( 30 ) and ischemia-reperfusion injury ( 31 ).…”

Anatomical Variations of the Tibialis Anterior Tendon Insertion: An Updated and Comprehensive Review

“…Treatment of TATR can be either conservative or surgical [12,34,35]. New studies have shown that surgical treatment is superior.…”

“…Typically, structures such as the plantaris tendon, extensor digitorum longus, extensor hallucis brevis and achilles tendon are used for this [29,38]. Sometimes an anterolateral thigh flap can also be used for soft tissue reconstruction [35]. The advantages of this structure, such as consistent and unchanged anatomy, long pedicle, localization (good distance from the ablative site) and allowing a two-team approach, enable it to be used for this purpose [39,40].…”