DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20222718
Published: 2022-10-27

Primary tendon repair in a case of acute traumatic tibialis anterior with extensor hallucis longus tendon rupture in a young male-a case report

Ravi Patel, Neetin P. Mahajan, Kunal Chaudhari, Pramod Bagimani, Akshay Gund

Abstract


Tibialis anterior tendon rupture is a rare entity which can be either traumatic and non-traumatic. It often presents late due to mild clinical symptoms and signs. Acute ruptures are traumatic occurring in young individuals while chronic ruptures are due to degenerative processes occurring in elderly individuals, commonly after 45 years of age. Tibia anterior along with extensor hallucis tendon is an even rarer entity, operative management of which becomes mandatory, more so in a young active individual for better outcome. We have a 31-year-old male patient, who presented to us with an acute post traumatic tibialis anterior tendon rupture of 3 days duration which was diagnosed following an initial clinical examination, an unremarkable X-ray picture, and Ultrasonography confirming the diagnosis. The patient was managed with primary repair of the tibialis anterior tendon along with Extensor hallucis tendon (which was found intra-operatively) with 2-0 ethibond sutures using a cross-linked Bunnell technique. The patient regained full ankle range of motion at 8 weeks post operative period with ankle dorsiflexion and great toe extension back to pre-injury state.As we have seen with this case, early primary repair in a case of acute rupture at tibialis anterior and extensor hallucis longus rupture with non-absorbable suture has significant improved post operative outcome in terms of return of the affected range of motion and can be practice safely in new hands with limited resources as material of suture and technique has not significant effect in post operative outcome. Acute tibialis anterior and extensor hallucis tendon rupture, non absorbable suture, ethibond, cross linked Bunnell technique.

 


Keywords


Acute tibialis anterior, Extensor hallucis tendon rupture, Non absorbable suture, Ethibond, Cross linked Bunnell technique

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References


Vosoughi AR, Heyes G, Molloy AP, Mason LW, Hoveidaei AH. Management of tibialis anterior tendon rupture: Recommendations based on the literature review. Foot Ankle Surg. 2020;26(5):487-93.

Ellington JK, McCormick J, Marion C, Cohen BE, Anderson RB, Davis WH et al. Surgical outcome following tibialis anterior tendon repair. Foot Ankle Int. 2010;31(5):412-7.

Markarian GG, Kelikian AS, Brage M, Trainor T, Dias L. Anterior tibialis tendon ruptures: an outcome analysis of operative versus nonoperative treatment. Foot Ankle Int. 1998;19:792-802.

Sammarco VJ, Sammarco GJ, Henning C, Chaim S. Surgical repair of acute and chronic tibialis anterior tendon ruptures. J Bone Joint Surg Am. 2009;91(2):325-32.

Jordan MC, Hoelscher-Doht S, Fehske K. Bunnell or cross-lock Bunnell suture for tendon repair? Defining the biomechanical role of suture pretension. J Orthop Surg Res. 2015;10:192.

Rawson S, Cartmell S, Wong J. Suture techniques for tendon repair; a comparative review. Muscles Ligaments Tendons J. 2013;3(3):220-28.

McCoy BW, Haddad SL. The strength of achilles tendon repair: a comparison of three suture techniques in human cadaver tendons. Foot Ankle Int. 2010;31(8):701-5.

Kocaoglu B, Ulku TK, Gereli A, Karahan M, Turkmen M. Evaluation of absorbable and nonabsorbable sutures for repair of achilles tendon rupture with a suture-guiding device. Foot Ankle Int. 2015;36(6):691-5.

Johansen JK, Jordan M, Thomas M, Walther M, Simatira AM, Waizy H. Surgical treatment of tibialis anterior tendon rupture. Foot Ankle Surg. 2021;27(5):515-20.

Mao H, Xu G. Soft tissue repair for tibialis anterior tendon ruptures using plate and screw fixation technique in combination with anterolateral thigh flaps transplantation. J Orthop Surg Res. 2015;10:143.