Sonography of Posterior Tibialis Tendon Dislocation

Dislocation of the Flexor Digitorum Longus and Posterior Tibial Tendons Without Fracture Dislocation of the Ankle: A Case Report

“…At followup, patients may have pain, and the dislocated tendon can be palpated or seen out of its usual place. 4,9,11 Bencardino et al 2 described the MRI findings in seven patients with posterior tibial tendon dislocation. The clinical diagnosis was suspected before imaging in just one patient.…”

“…6,13 -14 The exact mechanism of this injury is not well established, although dorsiflexion and inversion of the foot is a probable cause. 9 Soler et al 12 suggested hypoplasia of the retromalleolar groove to be a contributing factor. As in the present patient, this condition often is diagnosed late because clinical evaluation of an acutely injured ankle is difficult, and there is a tendency to diagnose a more common condition such as sprain of the deltoid ligament.…”

“…9 A history of trauma with or without fracture-dislocation of the ankle generally is present. 1 -3,10,12 -14 When this tendon becomes entrapped in a fracture-dislocation open reduction is mandatory.…”

“…The posterior tibial tendon was intact in six patients and the flexor retinaculum was stripped off the medial malleolus in five patients. Prato et al 9 described the value of ultrasound in the acute phase, depicting a traumatic dislocation of the posterior tibial tendon in a soccer player. Fluid was found in the retromalleolar groove, and the medial retinaculum was redundant and stripped off the medial malleolus.…”

“…7 The diagnosis of subluxation of the posterior tibial and FDL tendons may be delayed by the unawareness of the physician and the possibility of more common causes of pain near the medial malleolus. 4,9,11 Imaging methods are helpful to guide in the correct diagnosis, allowing the best treatment option for the patient. The aim of this report was to describe anterior subluxation of the posterior tibial and FDL tendons 1 without fracture-dislocation of the ankle, with emphasis on the imaging findings.…”