Treatment of a subcutaneous tibialis anterior tendon rupture with a semitendinosus autograft

Treatment of a subcutaneous tibialis anterior tendon rupture with a semitendinosus autograft

Authors

  • Hassan Zmerly 1 st orthopaedics Department - Villa Erbosa, Bologna, Italy
  • Marco Russo San Pier Damiano Hospital, Faenza (RA)
  • Matteo Ceccoli Villa Erbosa, Bologna, Italy
  • Manuela Moscato San Pier Damiano Hospital, Faenza (RA)
  • Ibrahim Akkawi Villa Erbosa, Bologna, Italy

Keywords:

Tibialis anterior tendon, rupture, tendon repair, tendon graft, semitendinosus

Abstract

The subcutaneous rupture of the tibialis anterior tendon is a rare and silent lesion which can lead to foot and ankle dysfunction with gait difficulty. The treatment can be either conservative or surgical. Conservative management is reserved for inactive patients and those with a general or local contraindication to surgery, whereas surgical repair includes direct and rotational suture, as well as tendon transfer and auto- or allograft. The choice of surgical treatment is based on multiple factors, including the symptoms, the timespan from injury to treatment, the anatomopathological pattern of the lesion, and the patient’s age and level of activity. Large defects present a particular reconstructive challenge, and there is no consensus on the optimal method of treatment. That being said, one of the options is an autograft using the semitendinosus hamstring tendon. We present a case of a 69-year-old woman who sustained a hyperflexion trauma to her left ankle. Three months later, ultrasound examination and a magnetic resonance imaging showed a complete tibialis anterior rupture with a gap of more than 10 cm. The patient was successfully treated with surgical repair. An autograft of the semitendinosus tendon was used to bridge the gap. The tibialis anterior rupture is a rare lesion that must be promptly diagnosed and treated, especially in physically active patients. Large defects pose particular challenges. Surgical management was found to be the treatment of choice. In the case of a lesion with a major gap, semitendinosus grafting can be successfully employed.

Author Biography

Hassan Zmerly, 1 st orthopaedics Department - Villa Erbosa, Bologna, Italy

 

 

References

Levitsky MM, Freibott CE, Greisberg JK, Vosseller JT. Risk Factors for Anterior Tibial Tendon Pathology. Foot Ankle Int. 2021 Mar;42(3):329-332. doi: 10.1177/1071100720963071. Epub 2020 Oct 14. PMID: 33689501.

Harkin E, Pinzur M, Schiff A. Treatment of Acute and Chronic Tibialis Anterior Tendon Rupture and Tendinopathy. Foot Ankle Clin. 2017 Dec;22(4):819-831. doi: 10.1016/j.fcl.2017.07.009. Epub 2017 Sep 28. PMID: 29078830.

Huh J, Boyette DM, Parekh SG, Nunley JA 2nd. Allograft Reconstruction of Chronic Tibialis Anterior Tendon Ruptures. Foot Ankle Int. 2015 Oct;36(10):1180-9. doi: 10.1177/1071100715589006. Epub 2015 Jun 3. PMID: 26041544.

Tickner A, Thorng S, Martin M, Marmolejo V. Management of Isolated Anterior Tibial Tendon Rupture: A Systematic Review and Meta-Analysis. J Foot Ankle Surg. 2019 Mar;58(2):213-220. doi: 10.1053/j.jfas.2018.08.001. Epub 2018 Dec 13. PMID: 30554867.

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 Jul;26(5):487-493. doi: 10.1016/j.fas.2019.06.003. Epub 2019 Jun 21. PMID: 31501017.

Siang DKT, Pitarini A, Koo K. Allograft Reconstruction of Spontaneous Tibialis Anterior Tendon Rupture in a Diabetic Patient. J Orthop Case Rep. 2019;9(3):57-60. doi: 10.13107/jocr.2250-0685.1420. PMID: 31559229; PMCID: PMC6742874.

Bekeny JC, Zolper EG, Fan KL, Evans KK. Composite Cutaneous Anterolateral Thigh Flap with Rolled Fascia Lata for Tibialis Anterior Tendon Reconstruction. Plast Reconstr Surg Glob Open. 2020 Jul 14;8(7):e2959. doi: 10.1097/GOX.0000000000002959. PMID: 32802653; PMCID: PMC7413756.

Funk SS, Gallagher B, Thomson AB. Repair of Chronic Tibialis Anterior Tendon Ruptures. Orthopedics. 2016 Mar-Apr;39(2):e386-90. doi: 10.3928/01477447-20160307-05. Epub 2016 Mar 11. PMID: 26966943.

Sammarco VJ, Sammarco GJ, Henning C, Chaim S. Surgical repair of acute and chronic tibialis anterior tendon ruptures. J Bone Joint Surg Am. 2009 Feb;91(2):325-32. doi: 10.2106/JBJS.G.01386. PMID: 19181976.

Jerome JT, Varghese M, Sankaran B, Thomas S, Thirumagal SK. Tibialis anterior tendon rupture in gout--case report and literature review. Foot Ankle Surg. 2008;14(3):166-9. doi: 10.1016/j.fas.2007.12.001. Epub 2008 Feb 20. PMID: 19083637.

Safar A, Bath O, Hernigou J, Moest E, Maes R, Callewier A. Surgical repair of a tibialis anterior tendon rupture : a case report. Acta Orthop Belg. 2020 Dec;86(4):697-701. PMID: 33861918.

Kim SJ, Park YU, Ahn JT, Kim HN. Reconstruction of chronic tibialis anterior tendon ruptures using a free anterior half of a peroneus longus tendon autograft: A technical note. J Orthop Surg (Hong Kong). 2022 Jan-Apr;30(1):10225536221083044. doi: 10.1177/10225536221083044. PMID: 35282738.

Burton A, Aydogan U. Repair of Chronic Tibialis Anterior Tendon Rupture With a Major Defect Using Gracilis Allograft. Foot Ankle Spec. 2016 Aug;9(4):345-50. doi: 10.1177/1938640015624757. Epub 2016 Jan 7. PMID: 26743874.

Kopp FJ, Backus S, Deland JT, O'Malley MJ. Anterior tibial tendon rupture: results of operative treatment. Foot Ankle Int. 2007 Oct;28(10):1045-7. doi: 10.3113/FAI.2007.1045. PMID: 17923052.

Goehring M, Liakos P. Long-term outcomes following anterior tibialis tendon reconstruction with hamstring autograft in a series of 3 cases. J Foot Ankle Surg. 2009 Mar-Apr;48(2):196-202. doi: 10.1053/j.jfas.2008.12.001. PMID: 19232972.

Ellington JK, McCormick J, Marion C, et al. Surgical outcome following tibialis anterior tendon repair. Foot Ankle Int. 2010 May;31(5):412-7. doi: 10.3113/FAI.2010.0412. PMID: 20460068.

Michels F, Van Der Bauwhede J, Oosterlinck D, Thomas S, Guillo S. Minimally invasive repair of the tibialis anterior tendon using a semitendinosus autograft. Foot Ankle Int. 2014 Mar;35(3):264-71. doi: 10.1177/1071100713517096. Epub 2013 Dec 20. PMID: 24363254.

Karnovsky SC, Desandis B, Papson AK, et al. Tibialis Anterior Reconstruction With Hamstring Autograft Using a Minimally Invasive Approach. Foot Ankle Int. 2018 May;39(5):535-541. doi: 10.1177/1071100717750883. Epub 2018 Mar 9. PMID: 29519148.

Kontogeorgakos V, Koutalos A, Hantes M, Manoudis G, Badras L, Malizos K. Traumatic tibialis anterior tendon rupture: treatment with a two-stage silicone tube and an interposition hamstring tendons graft protocol. Knee Surg Sports Traumatol Arthrosc. 2015 Mar;23(3):875-8. doi: 10.1007/s00167-013-2544-6. Epub 2013 Jun 5. PMID: 23736253.

Johansen JK, Jordan M, Thomas M, Walther M, Simatira AM, Waizy H. Surgical treatment of tibialis anterior tendon rupture. Foot Ankle Surg. 2021 Jul;27(5):515-520. doi: 10.1016/j.fas.2020.06.011. Epub 2020 Sep 9. PMID: 32948441.

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Published

23-06-2023

How to Cite

1.
Zmerly H, Russo M, Ceccoli M, Moscato M, Akkawi I. Treatment of a subcutaneous tibialis anterior tendon rupture with a semitendinosus autograft. Acta Biomed [Internet]. 2023 Jun. 23 [cited 2024 Jul. 17];94(S2):e2023086. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/13761