J Korean Foot Ankle Soc.  2023 Sep;27(3):99-102. 10.14193/jkfas.2023.27.3.99.

Chronic Longitudinal Rupture of the Tibialis Anterior Tendon: A Case Report

• Kim J

• KMID: 2545988
• DOI: http://doi.org/10.14193/jkfas.2023.27.3.99

Abstract

Acute rupture of the tibialis anterior tendon is rare, but the diagnosis is often delayed when it occurs. Acute rupture of the tibialis anterior tendon is often caused by minor trauma or it occurs spontaneously. Therefore, the diagnosis is more likely to be delayed. Among ruptures of the tibialis anterior tendon, longitudinal ruptures are less common and difficult to diagnose. Thus far, there are no reports of ruptures of the tibialis anterior tendon caused by direct trauma in Korea. This paper reports a case of chronic longitudinal tear of the tibialis anterior tendon caused by trauma in a 50-year-old male patient with no specific history of the disease, along with a review of the relevant literature.

Keyword

Extensor retinaculum; Longitudinal rupture; Rupture; Tibialis anterior

Figure

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  Figure 1 (A~C) Gross images of the left ankle upon initial visit. During active dorsiflexion of the ankle joints, the left ankle joint is less dorsiflexed as demonstrated in (A). Moreover, the left hindfoot is everted, the forefoot is pronated, and the tibialis anterior tendon is not protruded clearly. Active dorsiflexion of the right ankle joint was within the normal range (B), and active dorsiflexion of the left ankle joint was reduced compared to the left one (C).

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  Figure 2 Ultrasound image of the tibialis anterior muscle and tendon is shown in (A). There was no evidence of a definite tear (arrow). Magnetic resonance imaging images of the left ankle joint are presented in (B~D). The signal for the tibialis anterior tendon (arrows) at the ankle joint level is slightly increased; however, the continuity is preserved. The tibialis anterior tendon is not thickened or enlarged.

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  Figure 3 In the operating field, a partial rupture of the inferior extensor retinaculum is observed approximately 5 cm upward from the ankle joint (A); however, the continuity is maintained as shown in (B, C). The tibialis anterior tendon is exposed, and there is a longitudinal tear proximal and distal around the ankle joint. The total length of the tear is approximately 13 cm, and the proximal tear was about 10 cm longer. The tibialis anterior tendon rupture is multiple and linear in the longitudinal direction, which extends to the proximal muscle-tendon junction. Multiple longitudinal tears of the tibialis anterior tendon are concentrated in the distal part from the ankle joint, and the proximal part showed less ruptures with only one or two strands.

Reference

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