Surgical outcome following tibialis anterior tendon repair.
ABSTRACT Tibialis anterior tendon rupture is an uncommon injury that can cause significant functional deficit. Recent series have supported surgical reconstruction in younger, more active patients. We investigated our clinical outcomes of patients having undergone surgical management of tibialis anterior tendon ruptures.
Fifteen tibialis anterior tendon ruptures in 14 patients were retrospectively reviewed after surgical management. Five had primary repair, while 10 had tendon transfers. Average age at time of surgery was 70.6 years with an average followup of 27.2 months. Patients were evaluated with American Orthopaedic Foot and Ankle Society (AOFAS) and SF-36 clinical outcome scores. Strength measurements utilizing a dynamometer and range of motion (ROM) were documented on the operative and non-operative ankles. Patient satisfaction surveys were performed.
Average postoperative AOFAS hindfoot score was 88.8 and SF-36 score was 76.4. There was a statistically significant difference in average dorsiflexion strength of 21.8 lbs/in(2) on the operative side and 28.8 lbs/in(2) on the non-operative limb, and in dorsiflexion ROM of patients that received a gastrocnemius recession. There was no statistically significant difference between primary tendon repair versus tendon transfer groups nor plantarflexion strength or ROM among any group. Patient surveys revealed that seven patients were completely satisfied, six had minor reservations, and one had major reservations. There were no complications.
This study supports the surgical repair or reconstruction of the tibialis anterior tendon ruptures to restore functional strength and ROM.
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ABSTRACT: We present the case of a 42-year-old woman with chronic disruption of the tibialis anterior tendon who was treated by reconstructive surgery using autologous semitendinosus tendon grafting. Two incisional approaches, proximal and distal of the degenerative scar tissue between each ruptured stump, made it possible to preserve most of the extensor retinaculum, except for the inferior Y-shaped medial segment that was excised to prevent adhesion between the reconstructed tendon and the extensor retinaculum. Furthermore, by placing the proximal and distal suture knots far from the ends of the extensor retinaculum, impingement could be avoided between the knots using the Pulvertaft weave technique, and of the extensor retinaculum through movement of the ankle joint. Although some types of tendon transfer technique or interpositional autologous tendon grafting have been reported to show good outcomes for chronic tibialis anterior tendon disruption with a large defect, the recent trend has been toward reconstructive surgery using autografts. The surgical technique presented seems applicable for achieving minimum surgical complications in this rare condition.Archives of Orthopaedic and Trauma Surgery 09/2013; · 1.36 Impact Factor
- Foot & Ankle International 10/2011; 32(10):1012-5. · 1.63 Impact Factor
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ABSTRACT: A novel technique for managing ruptured tibialis anterior tendon complicated by infection and tendon substance loss in a young adult is described. A two-stage reconstruction technique with a silicon tube and tendon autograft was performed. At first, after local control of the infection, scar excision and placement of a silicone tube was performed. Ten weeks later, ipsilateral hamstrings tendons were harvested and bridged the 7 cm tendon gap. Eighteen months later, the patient has excellent clinical and functional outcome.Knee Surgery Sports Traumatology Arthroscopy 06/2013; · 2.68 Impact Factor