Tibialis anterior tendon traumatic rupture secondary to a closed talar neck fracture: A case report

Management of Anterior Tibialis Tendon Ruptures

Anterior tibialis tendon ruptures, while relatively infrequent ruptures, are commonly identified in delayed fashion, which can lead to significant impairments in patient gait and function. Surgical treatment is typically required to restore ankle dorsiflexion function and proper gait. Depending on various patient-specific factors, tendon quality and excursion, and chronicity, a range of treatment options are available to manage these patients, from nonsurgical care to surgical treatment. Surgical options include direct repair, local tendon transfer, autograft tendon reconstruction, and allograft tendon reconstruction. Additional procedures may need to be considered. Despite the variety of described surgical procedures, limited evidence-based guidelines are available to direct surgeons in the most optimal treatment for their patients. In addition to the relevant anatomy, biomechanics, and pathoanatomy, the reconstructive armamentarium is detailed and reviewed here, along with outcomes and potential complications, to guide surgeons in the most appropriate treatment for their patients.

Tendon Turndown to Bridge a Tibialis Anterior Gap and Restore Active Dorsiflexion After Degloving Foot Injury in a Child: A Case Report

CASE

A child with a severe degloving injury to the dorsum of the foot and ankle had segmental loss of the tibialis anterior tendon and toe extensors. A tendon turndown procedure was used, and the repaired tendon was covered with a latissimus muscle free flap to restore active ankle dorsiflexion. Details of the procedure are described, and active dorsiflexion and functional ambulation were restored.

CONCLUSIONS

The tendon turndown method is a simple and effective way to overcome segmental tendon loss of tibialis anterior and allowed restoration of active dorsiflexion in this case without relying on tendon transfers or grafting.