Avulsion fracture of the medial malleolus following posterior tibialis tendon dislocation: A case report (original) (raw)
Related papers
Tibialis posterior tendon injury associated with a closed medial malleolus fracture—a case report
Injury Extra, 2006
A 25-year-old healthy male solicitor was involved in a road traffic accident, being knocked off his motorbike by a car. He presented with an abrasion over the medial aspect of the right ankle and swelling of his right foot. The ankle was diffusely tender on the medial aspect and passive ankle movements were restricted and painful. There was no distal neurological deficit and posterior tibial and dorsalis pedis pulsations were palpable. Survey for associated skeletal injuries was negative.
Dislocation of the tibialis posterior tendon: Diagnosis and treatment
The Journal of Foot and Ankle Surgery, 1997
Traumatic dislocation of the tibialis posterior tendon occurred from minor ankle sprains in a 37-year-old male and a 53-year-old female. Both complained of local pain at the medial malleolus, and both walked with a limp. The diagnosis was suspected by clinical examination, in one case with 2 months' delay, and verified by ultrasound, computed tomography, and magnetic resonance imaging. The male patient was initially treated for an "uncomplicated ankle sprain. " For various reasons surgery was delayed 4 months. During this interval the male patient complained of pain and severe dysfunction, requiring analgesic treatment. A medial Achilles tendon flap was used to support the repositioned tendon. The female patient was operated on within 1 week from injury, by resuturing of the retinaculum over the tendon. Postoperatively, both patients were immobilized with below-knee casts for 6 weeks, allowing full weightbearing, followed by strength and stretching exercises. They were free of symptoms 2 and 3 months, respectively, after surgery. At follow-up 1 year postoperatively, both were asymptomatic and participated in activities like those before their injuries.
Tibialis Posterior Tendon Dislocation
JBJS Case Connector, 2020
Case: A 37-year-old man presented after a sudden snap followed by pain in the medial side of the ankle while playing football. Physical examination showed edema and pain posteriorly to the medial malleolus, and a longitudinal structure was palpable anteriorly. Ultrasound confirmed a dislocated tibialis posterior tendon (TPT). The patient underwent surgery, and the flexor retinaculum was repaired. Six months after the surgery, he was asymptomatic and had resumed his usual physical activity, with an AOFAS score of 100. Conclusion: TPT dislocation is rare and orthopaedic surgeons should be aware of this condition in patients with a sudden traumatic medial ankle pain.
Rupture of the tibialis posterior tendon in a closed ankle fracture: a case report
La Chirurgia Degli Organi Di Movimento, 2008
Rupture of the tibialis posterior tendon may occur during a trauma in pronation-external rotation of the foot or, less commonly, during a direct trauma of the ankle. When an isolated fracture of the medial malleolus is present, it is more likely that a direct trauma has occurred. A 36-year-old man with a non-displaced medial malleolar fracture was evaluated. Repair of the tendon and reduction of the fracture were performed. Twenty-four months after the operation, the fracture was completely healed, the patient was asymptomatic, he had a normal ankle range of motion, and the function and strength of the tibialis posterior tendon were equal to those on the contralateral side. Early surgical repair of the tibialis posterior tendon combined with malleolar fracture reduction is recommended to avoid progression to a plano-valgus foot.
Joints, 2016
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...
Traumatic Dislocation of the Posterior Tibial Tendon: A Case Report and Review of the Literature
Journal of Foot and Ankle Surgery (Asia Pacific), 2019
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.
Trauma Case Reports
Irreducible fracture dislocation of the ankle is a rare condition. Multiple cases have been described throughout the literature. Different known etiologies involve the distal fibula, deltoïd ligament and tendons of the posteromedial malleolar region. More specifically, trapping of the Posterior tibialis tendon has been described at several levels from the inside of the ankle joint, through the syndesmosis and in some cases in the fibula tibial interosseous space depending on the energy of trauma. We hereafter propose a case report and a review of previous cases of posterior tibialis tendon dislocation proximally in the interosseous space of the lower leg. The aim of this review is to point out common features and clues for early management in order to avoid overlooking these rare lesions as they may lead to major functional impairment of the ankle joint.
Journal of Orthopaedics, Trauma and Rehabilitation
Traumatic rupture of the posterior tibialis tendon is an extremely infrequent condition, which mostly occurred due to a traumatic mechanism of pronation and external rotation, less commonly in direct trauma on the medial side of the ankle. This lesion is overlooked preoperatively most of the time because of the limitation of physical examination owing to acute pain and swelling secondary to a medial malleolar fracture. Early diagnosis and treatment of this injury are very important to prevent the complications like acquired flatfoot deformity. Few cases have been described in the literature for the posterior tibialis tendon rupture associated with a closed ankle fracture. Here we report an acute rupture of the posterior tibialis tendon associated with a closed medial malleolar fracture after a high-energy trauma in a healthy 33-year-old man. We fixed the medial malleolar fracture with two screws and repaired the tendon with a direct end-to-end suture. We hope that our study can be h...