A new surgical technique for traumatic dislocation of posterior tibial tendon with avulsion fracture of medial malleolus

Year 2015, Volume: 49 Issue: 6, 690 - , 28.10.2015

Dae Cheol Nam , Soon-Taek Jeong Sun-Chul Hwang Dong-Hee Kim

Abstract

We introduce a case of traumatic dislocation of the posterior tibial tendon with avulsion fracture of the medial malleolus in a 52-year-old female patient who was treated surgically with periosteal flap and suture anchor fixation. Based in the posteromedial ridge of the distal tibia, a quadrilateral periosteal flap was created and folded over the tendon, followed by fixation on the lateral aspect of the groove by use of multiple suture anchors. Clinical and radiological findings 25 months postoperatively showed well-preserved function of the ankle joint with stable tendon gliding.

 

DOI: 10.3944/AOTT.2015.15.0021

Keywords

Periosteal flap; suture anchor; posterior tibial tendon.

References

• Oakley J, Yewlett A, Makwana N. Avulsion fracture of the medial malleolus following posterior tibialis tendon dislo- cation: a case report. Foot Ankle Surg 2011;17:94–7.
• Gambhir AK, Kay PR. Traumatic dislocation of tibi- alis posterior presenting late as a bony spur. Injury 1998;29:401–2.
• Marcus RE, Goodfellow DB, Pfister ME. The difficult di- agnosis of posterior tibialis tendon rupture in sports inju- ries. Orthopedics 1995;18:715–21.
• Prato N, Abello E, Martinoli C, Derchi L, Bianchi S. So- nography of posterior tibialis tendon dislocation. J Ultra- sound Med 2004;23:701–5.
• Schweitzer ME, Karasick D. MR imaging of disorders of the posterior tibialis tendon. AJR Am J Roentgenol 2000;175:627–35.
• Zwipp H, Dahlen C, Amlang M, Rammelt S. Injuries of the tibialis posterior tendon: diagnosis and therapy. [Ar- ticle in German] Orthopade 2000;29:251–9. [Abstract]
• Lohrer H, Nauck T. Posterior tibial tendon dislocation: a systematic review of the literature and presentation of a case. Br J Sports Med 2010;44:398–406.
• Soler RR, Gallart Castany FJ, Riba Ferret J, Garcia Ramiro S. Traumatic dislocation of the tibialis posterior tendon at the ankle level. J Trauma 1986;26:1049–52.
• Nuccion SL, Hunter DM, Difiori J. Dislocation of the posterior tibial tendon without disruption of the flexor retinaculum. A case report and review of the literature. Am J Sports Med 2001;29:656–9.
• Wong YS. Recurrent dislocation of the posterior tibial tendon secondary to detachment of a retinacular-perios- teal sleeve: a case report. Foot Ankle Int 2004;25:602–4.