title: Tibialis posterior tendon rupture associated with a closed medial malleolar fracture: a case report and review of the literature.
abstract: We report an acute rupture of a macroscopically normal tibialis posterior tendon in the setting of an acute closed ankle fracture. This injury is considered to be rare, although it is probably frequently overlooked preoperatively because of limitations of the clinical examination secondary to pain. The tibialis posterior tendon rupture was identified at the time of operative repair of the ankle fracture, and direct suture repair of the tendon was undertaken. After primary suture and osteosynthesis, the patient's progress was favorable and a satisfactory outcome was achieved. A clear history of the mechanism of injury as well as a high index of suspicion should be maintained, because failure to repair rupture of the tibialis posterior tendon, in the presence of an ankle fracture, is likely to lead to long-term patient disability and a planovalgus foot.
authors.affiliation: Department of Trauma and Orthopaedics, Southport and Ormskirk NHS Hospital Trust, Southport, UK. malcolmwest@nhs.net
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: West
authors.forename: Chetan
authors.initials: C
authors.lastname: Sangani
authors.forename: Eugene
authors.initials: E
authors.lastname: Toh
mesh_terms: D000058:Accidental Falls; D016512:Ankle Injuries / Q000175:diagnosis* / Q000601:surgery; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005593:Fracture Fixation, Internal; D005596:Fractures, Closed / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012421:Rupture; D013708:Tendon Injuries / Q000175:diagnosis* / Q000601:surgery