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손상된 후경골건 감입에 의한 족관절 골절 및 탈구의 정복 실패: 증례 보고

A Irreducible Ankle Fracture and Dislocation Due to Injured Tibialis Posterior Tendon Interposition: A Case Report

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Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

Abstract

Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

참고문헌 (10)

  1. Ermis MN, "Irreducible fracture dislocation of the ankle caused by tibialis posterior tendon interposition", J Foot Ankle Surg, 49, pp.166~171 (2010)
  2. Lacasse JS, "Irreducible fracture-dislocation of the ankle associated with interposition of the tibialis posterior tendon in the syndesmosis : a case report", J Foot Ankle Surg, 54, pp.962~966 (2015)
  3. Jarvis HC, "Acute tibialis posterior tendon rupture associated with a distal tibial fracture", Orthopedics, 35, pp.e595~e597 (2012)
  4. Walker RH, "Irreducible fracture-dislocations of the ankle associated with interposition of the tibialis posterior tendon:case report and review of the literature of a specific ankle fracture syndrome", Clin Orthop Relat Res, (160), pp.212~216 (1981)
  5. Hunter AM, "Posterior tibial tendon entrapment within an intact ankle mortise : a case report", J Foot Ankle Surg, 54, pp.116~119 (2015)
  6. Giblin MM, "Ruptured tibialis posterior tendon associated with a closed medial malleolar fracture", Aust N Z J Surg, 50, pp.59~60 (1980)
  7. West MA, "Tibialis posterior tendon rupture associated with a closed medial malleolar fracture: a case report and review of the literature", J Foot Ankle Surg, 49, pp.565.e9~565.e12 (2010)
  8. Coonrad RW, "Trapping of the posterior tibial tendon and interposition of soft tissue in severe fractures about the ankle joint", J Bone Joint Surg Am, 36, pp.744~750 (1954)
  9. Cunningham DJ, "Cunningham’s textbook of anatomy" (1981), Oxford University Press
  10. Holmes GB Jr, "Possible epidemiological factors associated with rupture of the posterior tibial tendon", Foot Ankle, 13, pp.70~79 (1992)

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