Tibialis Anterior Rupture
synonyms:
Tibialis Anterior Rupture ICD-9
- 845.00 ( sprains and strains of ankle and foot: unspecified site)
Tibialis Anterior Rupture Etiology / Epidemiology / Natural History
- Uncommon
- Occurs from blunt trauma or tendon laceration. Atraumatic ruptures can occur following eccentric loading of a plantar flexed foot, generally in men >45yrs old.
- Risk factors: inflammatory arthritis, gout, diabetes mellitus, corticosteriod use.
Tibialis Anterior Rupture Anatomy
- Tibialis Anterior:Innervation = deep peroneal nerve (L4); origin = lateral tibia; insertion = medial cuneiform and 1st metatarsal; functions to dorsiflex foot.
- See also Ankle Anatomy.
Tibialis Anterior Rupture Clinical Evaluation
- Anterior ankle pain
- Drop foot; ankle dorsiflexion weakness
- Loss of the countour of the tibialis anterior tendon on the anterior ankle.
- EHL and EDC are used to dorsiflex ankle
- May have stappage or flat-slpping gait or tendency to toe-drag.
- Classic Triad: (1)pseudotumor at the anterior part of the ankle that corresponds with the ruptured tendon end, (2)loss of the normal contour of the tendon, (3)weak dorsiflexion. (Sammarco VJ, JBJS 2009;91A:325)
Tibialis Anterior Rupture Xray / Diagnositc Tests
- A/P, mortise and lateral ankle xray indicated to r/o fracture or avulsion. Avulsion fx best seen on lateral xray
Tibialis Anterior Rupture Classification / Treatment
- Ankle-foot orthosis: generally for elderly patients with low functional demand and delayed presentation (>3 months old)
- Acute rupture generally treated with direct repair or suture anchor reattachment of avulsions. (Sammarco VJ, JBJS 2009;91A:325).
- Chronic rupture: plantaris tendon graft/extensor digitorum longus graft (Sammarco VJ, JBJS 2009;91A:325)
Tibialis Anterior Rupture Associated Injuries / Differential Diagnosis
Tibialis Anterior Rupture Complications
Tibialis Anterior Rupture Follow-up Care
Tibialis Anterior Rupture Review References
- Sammarco VJ, JBJS 2009;91A:325
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