Transfer of the posterior tibial tendon to a rerouted anterior tibial tendon and transfer of the flexor digitorum longus to the extensor hallucis longus through four limited incisions in cases of drop foot

2015 ◽  
Vol 6 (4) ◽  
pp. 315-321
Author(s):  
Mohamed Mokhtar Abd-Ella ◽  
Ahmed Naeem Atiyya
Keyword(s):  
Posterior Tibial Tendon ◽  
Drop Foot ◽  
Flexor Digitorum Longus ◽  
Posterior Tibial ◽  
Extensor Hallucis Longus ◽  
Anterior Tibial ◽  
Anterior Tibial Tendon ◽  
Flexor Digitorum

scholarly journals Anterior Tibial Tendon Side-to-Side Tenorrhaphy after Posterior Tibial Tendon Transfer: A Technique to Improve Reliability in Drop Foot after Common Peroneal Nerve Injury

2021 ◽  
Author(s):  
Miguel Estuardo Rodríguez-Argueta ◽  
Carlos Suarez-Ahedo ◽  
César Alejandro Jiménez-Aroche ◽  
Irene Rodríguez-Santamaria ◽  
Francisco Javier Pérez-Jiménez ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Tendon Transfer ◽  
Common Peroneal Nerve ◽  
Posterior Tibial Tendon ◽  
Drop Foot ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Tibial Tendon ◽  
Peroneal Nerve Injury ◽  
Improve Reliability

Bilateral Posterior Tibial Tendon and Flexor Digitorum Longus Dislocations

2016 ◽  
Vol 10 (2) ◽  
pp. 162-166
Author(s):  
Eric M. Padegimas ◽  
David M. Beck ◽  
David I. Pedowitz
Keyword(s):  
Physical Therapy ◽  
Suture Anchor ◽  
Plantar Flexion ◽  
Posterior Tibial Tendon ◽  
Flexor Digitorum Longus ◽  
Posterior Tibial ◽  
Left Ankle ◽  
The Right ◽  
Flexor Digitorum ◽  
Suture Anchor Repair

The authors present a case of a previously healthy and athletic 17-year-old female who presented with a 3.5-year history of medial left ankle pain after sustaining an inversion injury while playing basketball. Prior to presentation, she had failed prior immobilization and physical therapy for a presumed ankles sprain. Physical examination revealed a dislocated posterior tibial tendon (PTT) that was temporarily reducible, but would spontaneously dislocate immediately after reduction. She had pain and snapping of the PTT with resisted ankle plantar flexion and resisted inversion as well as 4/5 strength in ankle inversion. The diagnosis of dislocated PTT was confirmed on magnetic resonance imaging (MRI). The patient underwent suture anchor repair of the medial retinaculum of the left ankle. At the time of surgery both the PTT and flexor digitorum longus (FDL) were dislocated. Three months postoperatively, the patient represented with PTT dislocation of the right (nonoperative) ankle confirmed by MRI. After failure of immobilization, physical therapy, and oral anti-inflammatory medications, the patient underwent suture anchor repair of the medial retinaculum of the right ankle. At 6 months postoperatively, the patient has 5/5 strength inversion bilaterally, no subluxation of either PTT, and has returned to all activities without limitation. The authors present this unique case of bilateral PTT dislocation and concurrent PTT/FDL dislocation along with review of the literature for PTT dislocation. The authors highlight the common misdaiganosis of this injury and highlight the successful results of surgical intervention. Levels of Evidence: Level V: Case report

scholarly journals Medial Structure Injury During Suture Button Insertion Utilizing “Center-Center” Technique for Syndesmotic Stabilization

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0010
Author(s):  
Christopher Reb ◽  
Roberto Brandao ◽  
Bryan Van Dyke ◽  
Gregory Berlet ◽  
Mark Prissel
Keyword(s):  
Saphenous Vein ◽  
Drill Hole ◽  
Saphenous Nerve ◽  
Posterior Tibial Tendon ◽  
Reliable Technique ◽  
Anatomic Structure ◽  
Suture Button ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Tibial Tendon

Category: Ankle Introduction/Purpose: The “Center-Center” technique for syndesmosis fixation has been described as an improved and reliable technique for proper reduction of the syndesmosis during ankle fracture repair. Concurrently, the use of a flexible suture button is becoming an established means of syndesmotic stabilization. The purpose of this cadaveric study was to assess for medial structure injury during the placement of a suture button utilizing the “Center-Center” technique for ankle syndesmotic repair at 3 insertion intervals. Methods: Simulated open syndesmosis repair was performed on 10 cadaveric specimens. Three intervals were measured at 10 mm, 20 mm, and 30 mm proximal to the level of the distal tibial articular surface along the fibula. Proper longitudinal alignment of the “Center-Center” technique was completed under fluoroscopic guidance and was marked on the medial aspect of the tibia. The 3 intervals were drilled in the appropriate technique trajectory. The suture button was passed through each drill-hole interval. Using a digital caliper, the distance was measured from each suture button aperture with respect to the anterior tibial tendon, posterior tibial tendon, greater saphenous vein and nerve by single observer. Results: The average distance from the suture button to each anatomic structure was -2.61 ± 3.75 mm for the greater saphenous vein, -3.44 ± 6.82 mm for the saphenous nerve, 15.09 ± 4.02 mm for the anterior tibial tendon, and -21.70 ± 4.89 mm for the posterior tibial tendon. Direct impingement of the greater saphenous vein was seen in 11/30 (36.6%) interval measurements. Six of the 11 (54.5%) entrapment intervals occurred at the 10 mm drill hole. Conclusion: The results of the present study suggest the use of the “Center-Center” technique for syndesmotic repair with suture button application does involve risk of injury to the greater saphenous vein and saphenous nerve. These injuries could manifest as persistent lower extremity edema and paresthesias for injury to the saphenous vein and nerve respectively. The “Center-Center” technique with suture button fixation may warrant a minimal medial open dissection, prior to quadricortical drilling, for optimal placement to prevent neurovascular injury.

Combined Rupture of the Anterior Tibial and Posterior Tibial Tendons: A New Clinical Entity

1994 ◽  
Vol 15 (9) ◽  
pp. 508-511 ◽  
Author(s):  
Tye J. Ouzounian
Keyword(s):  
Severe Pain ◽  
Tendon Rupture ◽  
Elderly Women ◽  
Valgus Deformity ◽  
Clinical Entity ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Tibial Tendon ◽  
Significant Clinical Improvement

Two patients with combined rupture of the anterior tibial tendon and posterior tibial tendon are described. Both were elderly women with a gradually progressive valgus deformity of the ankle/hindfoot and severe pain. Arthrodesis procedures were performed in both patients; however, postoperative complications prevented significant clinical improvement. This combined tendon rupture is presented to document a new clinical entity.

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