title: Closed Medial Malleolar Multifragment Fracture With a Posterior Tibialis Tendon Rupture: A Case Report and Review of the Literature.
abstract: Ankle fractures represent an exciting field of traumatology because of the wide variety of clinical presentations, injury mechanisms, and treatment options. Rupture of the posterior tibialis tendon (PTT) with ankle fracture can occur during trauma that involves pronation and external rotation of the foot or, less commonly, secondary to direct trauma to the ankle. This tendon injury is uncommon and probably misdiagnosed in many cases, because of the difficult clinical examination secondary to the pain and swelling. The identification and early treatment of PTT tears is essential for good functional outcomes to prevent the main mid- to long-term complication of disabling acquired flatfoot due to tendon failure. In the present report, we provide a review of the published data regarding ankle fractures associated with PTT rupture and describe our experience with a case of a multifragment medial malleolus fracture and complete rupture of the PTT diagnosed intraoperatively and surgically treated in a 34-year-old male, with 2.5 years of follow-up.
authors.affiliation: Orthopaedic Clinic, IRCCS S. Martino IST, Genoa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Formica
authors.affiliation: Ortopaedic and Traumatology Unit, IRCCS S. Martino IST, Genoa, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Santolini
authors.affiliation: Orthopaedic Clinic, IRCCS S. Martino IST, Genoa, Italy. Electronic address: mattia.alessio@hotmail.com.
authors.forename: Mattia
authors.initials: M
authors.lastname: Alessio-Mazzola
authors.affiliation: Orthopaedic Clinic, IRCCS S. Martino IST, Genoa, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Repetto
authors.affiliation: Orthopaedic Clinic, IRCCS S. Martino IST, Genoa, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Andretta
authors.affiliation: Ortopaedic and Traumatology Unit, IRCCS S. Martino IST, Genoa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Stella
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D064386:Ankle Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery; D056888:Patient Positioning; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D020127:Recovery of Function; D018570:Risk Assessment; D012421:Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013710:Tendons / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: ankle fracture; diagnosis; flatfoot; malleolus; tibialis posterior tendon rupture