Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review

We report a case of equinus foot deformity and malunion of the medial malleolus caused due to tibialis posterior tendon interposition following irreducible fracture-dislocation of the ankle. A 19-year-old female patient was referred to our hospital with the chief complaint of persistent ankle pain a...

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Main Authors: Toshifumi Hikichi, Hidenori Matsubara, Kanu Shimokawa, Koji Watanabe, Hiroyuki Tsuchiya
Format: Article
Language:English
Published: Elsevier 2022-04-01
Series:Trauma Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352644022000140
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author Toshifumi Hikichi
Hidenori Matsubara
Kanu Shimokawa
Koji Watanabe
Hiroyuki Tsuchiya
author_facet Toshifumi Hikichi
Hidenori Matsubara
Kanu Shimokawa
Koji Watanabe
Hiroyuki Tsuchiya
author_sort Toshifumi Hikichi
collection DOAJ
description We report a case of equinus foot deformity and malunion of the medial malleolus caused due to tibialis posterior tendon interposition following irreducible fracture-dislocation of the ankle. A 19-year-old female patient was referred to our hospital with the chief complaint of persistent ankle pain and restricted ankle dorsiflexion. Her medical history revealed a fracture-dislocation of the ankle in the left tibia at the age of 18 years. Open reduction and osteosynthesis were performed 3 days after injury. One year after the operation, ankle pain and restricted ankle dorsiflexion persisted. Computed tomography revealed malunion of the medial malleolus and an irregular groove in the interosseous space between the tibia and fibula. Magnetic resonance imaging revealed entrapment of the tibialis posterior tendon within the posterior talocrural joint and syndesmosis, preventing posterior translation of the talus back to its normal position and forcing the fibula to remain anteriorly displaced in the syndesmosis. We performed several procedures, including reduction of the tibialis posterior tendon interposition and dislocation of the talus, augmentation of the tibio-fibular ligament, and recession of the gastrocnemius. Finally, the patient achieved plantigrade stance and improvement in her Japanese Society for Surgery of the foot ankle/hindfoot scale from 42 to 82 points, after a 2-year follow-up. Anterior impingement caused the patient to experience severe osteoarthritis. Early reduction of the tibialis posterior tendon should have been achieved for this case. Age, fracture type, and severely restricted range of motion should raise suspicion of this adverse event.Level of Clinical Evidence: 4.
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spelling doaj.art-071aa3ad641347acafadb5ba639f78372022-12-22T01:00:16ZengElsevierTrauma Case Reports2352-64402022-04-0138100618Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature reviewToshifumi Hikichi0Hidenori Matsubara1Kanu Shimokawa2Koji Watanabe3Hiroyuki Tsuchiya4Department of Orthopaedic Surgery, Kanazawa University Hospital 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, JapanDepartment of Orthopaedic Surgery, Kanazawa University Hospital 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan; Corresponding author at: Department of Orthopaedic Surgery, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.Department of Orthopaedic Surgery, Kanazawa University Hospital 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, JapanWatanabe orthopaedic hospital, 4-1-11 izuminode-machi, Kanazawa, Ishikawa, 921-8116, JapanDepartment of Orthopaedic Surgery, Kanazawa University Hospital 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, JapanWe report a case of equinus foot deformity and malunion of the medial malleolus caused due to tibialis posterior tendon interposition following irreducible fracture-dislocation of the ankle. A 19-year-old female patient was referred to our hospital with the chief complaint of persistent ankle pain and restricted ankle dorsiflexion. Her medical history revealed a fracture-dislocation of the ankle in the left tibia at the age of 18 years. Open reduction and osteosynthesis were performed 3 days after injury. One year after the operation, ankle pain and restricted ankle dorsiflexion persisted. Computed tomography revealed malunion of the medial malleolus and an irregular groove in the interosseous space between the tibia and fibula. Magnetic resonance imaging revealed entrapment of the tibialis posterior tendon within the posterior talocrural joint and syndesmosis, preventing posterior translation of the talus back to its normal position and forcing the fibula to remain anteriorly displaced in the syndesmosis. We performed several procedures, including reduction of the tibialis posterior tendon interposition and dislocation of the talus, augmentation of the tibio-fibular ligament, and recession of the gastrocnemius. Finally, the patient achieved plantigrade stance and improvement in her Japanese Society for Surgery of the foot ankle/hindfoot scale from 42 to 82 points, after a 2-year follow-up. Anterior impingement caused the patient to experience severe osteoarthritis. Early reduction of the tibialis posterior tendon should have been achieved for this case. Age, fracture type, and severely restricted range of motion should raise suspicion of this adverse event.Level of Clinical Evidence: 4.http://www.sciencedirect.com/science/article/pii/S2352644022000140Tibialis posterior interpositionIrreducible fracture-dislocation of the ankleEquinus deformityCorrective osteotomy
spellingShingle Toshifumi Hikichi
Hidenori Matsubara
Kanu Shimokawa
Koji Watanabe
Hiroyuki Tsuchiya
Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review
Trauma Case Reports
Tibialis posterior interposition
Irreducible fracture-dislocation of the ankle
Equinus deformity
Corrective osteotomy
title Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review
title_full Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review
title_fullStr Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review
title_full_unstemmed Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review
title_short Equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle: A case report and literature review
title_sort equinus foot deformity and malunion of the medial malleolus caused by tibialis posterior tendon interposition following irreducible fracture dislocation of the ankle a case report and literature review
topic Tibialis posterior interposition
Irreducible fracture-dislocation of the ankle
Equinus deformity
Corrective osteotomy
url http://www.sciencedirect.com/science/article/pii/S2352644022000140
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