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Muscle activity in unrecognised rupture of tibialis anterior tendon


MOJ Orthopedics & Rheumatology
Nuria Boó Gustems,1 Laia López Capdevila,1 Luis Llurda- Almuzara,2 Amaia Endemaño Lucio,1 Alejandro Domínguez Sevilla,1 Jorge Román Verdasco,1 Jordi Montanyà Manich1

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Abstract

There isn't a clear consensus on the appropriate management of anterior tibial tendon ruptures. Generally, the proposed treatment differs if the case is an acute rupture in a young patient or a degenerative chronic rupture in older patients. A major disadvantage of this kind of ruptures is that they often go overlooked and are late-diagnosed involving a significant retraction of the tendon and the use of repair techniques by means of autografts and tendon transfer surgeries. We describe the case of a 39 years old man with a chronic traumatic rupture of the tibialis anterior tendon who underwent a repair by Z-plasty. A gait analysis was performed through a biomechanical and electromiography study both preoperative and postoperative, which resulted in a clear improvement of strength and an increase of the muscle fibre recruitment during gait 3 months after the procedure and a progressive improvement after 9 months of the operation.

 

A direct suture by Z-plasty in a chronic rupture of the tibialis anterior tendon can be useful in specific cases presenting defects up to 4 cm with a strength recovery, articular balance and muscle fibre recruitment similar to the healthy limb.

Keywords

tendon reconstruction, tendon graft, ankle

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