title: Dislocated Posterior Tibial Tendon Treated With Plate Buttress Fixation in a Collegiate Gymnast: A Case Report and Review of the Literature.
abstract: Dislocation of the posterior tibial tendon (PTT) is a rare pathological process that occurs most often as a result of acute trauma. The injury involves forced dorsiflexion and eversion of the foot against a contracted posterior tibialis. Diagnosis of the injury is often difficult secondary to the rarity of the injury and its similarity with other benign injuries of the medial ankle. Routine diagnostic imaging often does not reveal the injury, and advanced imaging with magnetic resonance imaging or ultrasound to confirm the diagnosis is often required. The injury can be a result of an abnormal retromalleolar groove or a tear of the flexor retinaculum. Because nonoperative treatment frequently results in poor outcomes with continuing pain and progressive flat foot, operative treatment with repair of the flexor retinaculum with correction of the retromalleolar groove is the most described intervention. We report an acute case of PTT dislocation in a collegiate gymnast during competition and offer our technique for surgical correction in the setting of a partially torn, attenuated flexor retinaculum with plate buttressing of the PTT into its native uncorrected groove.
  
  
  METHODS
  Therapeutic, Level IV: Case study.
authors.affiliation: Department of Orthopedic Surgery, University of South Alabama, Mobile, Alabama (JM)Andrews Research and Education Institute, Foot and Ankle Center, Gulf Breeze, Florida (WW, EN, CK).
authors.forename: Jess
authors.initials: J
authors.lastname: Mullens
authors.affiliation: Department of Orthopedic Surgery, University of South Alabama, Mobile, Alabama (JM)Andrews Research and Education Institute, Foot and Ankle Center, Gulf Breeze, Florida (WW, EN, CK) will.whiteside@yahoo.com.
authors.forename: William
authors.initials: W
authors.lastname: Whiteside
authors.affiliation: Department of Orthopedic Surgery, University of South Alabama, Mobile, Alabama (JM)Andrews Research and Education Institute, Foot and Ankle Center, Gulf Breeze, Florida (WW, EN, CK).
authors.forename: Erik
authors.initials: E
authors.lastname: Nilssen
authors.affiliation: Department of Orthopedic Surgery, University of South Alabama, Mobile, Alabama (JM)Andrews Research and Education Institute, Foot and Ankle Center, Gulf Breeze, Florida (WW, EN, CK).
authors.forename: Chad
authors.initials: C
authors.lastname: Kennedy
mesh_terms: D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy; D001860:Bone Plates; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D005260:Female; D005413:Flatfoot / Q000209:etiology / Q000601:surgery; D006173:Gymnastics / Q000293:injuries*; D006801:Humans; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
keywords: chondral injury; flexor retinaculum insufficiency; plate fixation; posterior tibial tendon; tibiotalar subluxation