Traumatic rupture of the tibialis posterior tendon after closed ankle fractures: A report of two cases

Mallick, S.; Falémé, A.

doi:10.1007/bf01682498

Cited by 14 publications

(22 citation statements)

References 5 publications

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“…This type of injury is rare, with only 23 previously reported cases over the last 35 years. 1,[3][4][5][6][7][8][9][11][12][13][14][15][16][17][18] In concert with the current findings, the most common mechanism of injury includes forced pronation, external rotation, and dorsiflexion of the ankle, which places maximal stress on the tibialis posterior tendon. However, direct trauma to the tendon medially also may occur.…”

Section: Discussionmentioning

confidence: 79%

“…2,17 Most cases involve a high-energy mechanism of injury, such as a motor vehicle collision or a fall from height. [1][2][3][4][5][6][7][8][9][10][13][14][15][16][17][18] However, lower-energy athletic injuries also have been described. 11,12 Rupture frequently occurs in a relatively hypovascular segment of the tendon, corresponding approximately to the level of the fracture site posteromedi-ally, which may indicate that the tendon lacerates against it.…”

Section: Discussionmentioning

confidence: 99%

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Acute Tibialis Posterior Tendon Rupture With Pronation-Type Ankle Fractures

Bernstein¹,

Harris²,

Cosculluela³

et al. 2016

Orthopedics

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Tibialis posterior tendon rupture in the setting of pronation-type ankle fractures can lead to long-term debility as a result of chronic tendon dysfunction. This rare injury pattern presents a diagnostic challenge because thorough preoperative examination of the function of the tendon is limited by pain, swelling, and inherent instability of the fracture. As such, a high index of suspicion is necessary in ankle fractures with radiographs showing a medial malleolus fracture with an associated suprasyndesmotic fibula fracture. This report describes 3 cases of tibialis posterior tendon rupture associated with pronation-type ankle fractures treated acutely with open reduction and internal fixation and primary tendon repair. Additionally, common features of this injury pattern are discussed based on the current literature. In accordance with this report, the typical mechanism of injury is high energy and includes forced pronation, external rotation, and dorsiflexion of the ankle, which places maximal stress on the tibialis posterior tendon. Rupture most commonly occurs in a relatively hypovascular area of the tendon located at the posteromedial extent of the medial malleolus fracture. In the operative treatment of pronation-type ankle fractures, direct inspection of the tibialis posterior tendon allows for timely diagnosis and treatment of associated ruptures. [Orthopedics.2016; 39(5):e970-e975.].

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Acute Tibialis Posterior Tendon Rupture With Pronation-Type Ankle Fractures

Bernstein¹,

Harris²,

Cosculluela³

et al. 2016

Orthopedics

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“…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.…”

Section: Introductionmentioning

confidence: 84%

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

Vosoughi

Ravanbod

Gilheany

et al. 2018

Hong Kong Journal of Emergency Medicine

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Introduction: Traumatic rupture of posterior tibialis tendon in association with medial malleolus fracture is extremely rare. Case Presentation: We demonstrate our experience in the management of a complete posterior tibialis tendon (PTT) rupture and anterior talofibular ligament avulsion fracture from the talus in association with medial malleolus fracture in a 30-year-old male motorcyclist without any open wounds. Discussion: We believe this to be the first reported injury of this type in the literature. Closed ankle fractures may obscure surrounding tendon rupture and the clinician may be tempted to focus on the osseous injuries rather than the significance of associated soft tissue injures. Conclusion: This particular case demonstrates the importance of assessing for PTT injury in situations where high velocity impact to the ankle results in malleolar fracture.

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“…Our patient had no preexisting tendon rupture risk factors, such as rheumatoid arthritis or obesity. 12 Therefore, the acute tibial fracture can be assumed to be the rupture cause. Case reports have been published demonstrating medial bone flakes as 1 possible radiographical sign that may suggest a tibialis posterior tendon injury in ankle fractures.…”

Section: Discussionmentioning

confidence: 99%

Acute Tibialis Posterior Tendon Rupture Associated With a Distal Tibial Fracture

Jarvis¹,

Cannada²

2012

Orthopedics

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Tibialis posterior tendon ruptures associated with closed medial malleolar fractures are rare. This article describes the association of tibialis posterior tendon ruptures with closed, high-energy, distal tibia fractures. Tendon ruptures are likely to be identified intraoperatively or missed if clinical evaluation at acute injury is limited. A high index of suspicion is required to diagnose this injury. The consequences of an unrecognized tibialis posterior tendon rupture include progressive, painful pes planus deformities due to the unopposed action of the peroneus brevis muscle and lack of support of the medial longitudinal arch. Secondary operative intervention may be required. This article describes an intraoperative tenodesis technique between the tibialis posterior and flexor digitorum longus tendons when direct repair is not possible.A 48-year-old woman sustained a closed AO/Orthopaedic Trauma Association type 43A right lower-extremity distal tibia fracture and a traumatic left knee arthrotomy. Temporary stabilization with an external fixator was performed, followed by open reduction and internal fixation of the distal tibial fracture 6 days later. A periarticular nonlocking medial plate was applied, and the tibialis posterior tendon was shortened. We performed a direct tenodesis to the flexor digitorum longus tendon. At 1-year follow-up, the patient had made excellent progress, with no detectable muscle weakness, and was able to perform a single-leg toe raise.A review of the literature suggested which features of radiological evidence of tendon rupture should be examined, which may be useful in the current era considering most high-energy distal tibia or pilon fractures undergo examination with computed tomography.

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Traumatic rupture of the tibialis posterior tendon after closed ankle fractures: A report of two cases

Cited by 14 publications

References 5 publications

Acute Tibialis Posterior Tendon Rupture With Pronation-Type Ankle Fractures

Acute Tibialis Posterior Tendon Rupture With Pronation-Type Ankle Fractures

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

Acute Tibialis Posterior Tendon Rupture Associated With a Distal Tibial Fracture

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