A 27-year-old man with a high-energy, open-fracture dislocation of the ankle underwent debridement and open reduction of his injuries. During surgery a disruption-laceration of the posterior tibial tendon at the level of the fracture of the medial malleolus was found. Repair required location of the proximal muscle and tendon and controlled traction of the musculotendinous unit from its retracted position. Common aspects in the nine previously reported instances of this lesion include relatively high energy of the injury and the fracture type, a transverse fracture in the medial malleolus. Unique to this case was the open injury.
Get full access to this article
View all access options for this article.
References
1.
. DeZwartD.F.DavidsonJ.S.: Rupture of the posterior tibial tendon associated with fractures of the ankle. J. Bone Joint Surg., 65A:260–262, 1983.
2.
. FreyC.ShereffM.GreenidgeN.: Vascularity of the posterior tibial tendon. J. Bone Joint Surg., 72A:884–888, 1990.
3.
. FinkD.S.CassJ.R.JohnsonK.A.: Acquired adult flatfoot secondary to posterior tibial tendon pathology. J. Bone Joint Surg., 68A:95–102, 1986.
4.
. GiblinM.M.: Ruptured tibialis posterior tendon associated with a closed medial malleolus fracture. Aust. N. Z. J. Surg., 50:59–60, 1980.
5.
. HencerothW.D.IIDeyerleW.M.: The acquired unilateral flatfoot in the adult: some causative factors. Foot Ankle, 2:304–308, 1982.
6.
. HolmesG.B.Jr.MannR.A.: Possible epidemiological factors associated with rupture of the posterior tibial tendon. Foot Ankle, 13:70–79, 1992.
7.
. JahssM.H.: Disorders of the Foot and Ankle. Philadelphia, W.B. Saunders, 1991.
. KayeR.A.JahssM.H.: Tibialis posterior: a review of anatomy and biomechanics in relation to support of the medial longitudinal arch. Foot Ankle, 11:244–247, 1991.
10.
. KelbelM.JardonO.M.: Rupture of the tibialis posterior tendon in a closed ankle fracture. J. Trauma, 22:1026–1027, 1982.
11.
. MannR.A.: Surgery of the Foot and Ankle, Ed. 5. St. Louis, C.V. Mosby, 1993.
12.
. MannR.A.ThompsonF.M.: Rupture of the posterior tibial tendon causing flat foot. J. Bone Joint Surg., 67A:556–561, 1985.
13.
. SchafferJ.J.LockT.R.SalciccioliG.G.: Posterior tibial tendon rupture in pronation-external rotation ankle fractures. J. Trauma, 27:795–796, 1987.
14.
. SoballeK.Kjaersgaard-AndersonP.: Ruptured tibialis posterior tendon in a closed ankle fracture. Clin. Orthop.231:140–143, 1988.
15.
. SteinR.E.: Rupture of the posterior tibial tendon in closed ankle fractures. J. Bone Joint Surg., 67A:493–494, 1985
