Anterior Tibialis Tendon Ruptures: An Outcome Analysis of Operative Versus Nonoperative Treatment

Foot and Ankle International - Tập 19 Số 12 - Trang 792-802 - 1998
Greory G. Markarian1, Armen S. Kelikian2, Michael E. Brage3, Timothy J. Trainor4, Luciano Dias5
1Attending Orthopedic Surgeon, Edward Hospital, Naperville, Illinois.
2Associate Professor of Orthopedic Surgery, Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, Illinois.
3Assistant Professor of Orthopedic Surgery, University of California, San Diego Medical Center, San Diego, California.
4Orthopedic Surgery Resident, Georgetown University Medical Center, Washington, DC.
5Professor of Orthopedic Surgery, Northwestern University Medical School, Children's Memorial Hospital, Chicago, Illinois.

Tóm tắt

Ruptures of the anterior tibialis tendon are a rare clinical entity. Case reports in the literature reveal a total of 28 cases. Unfortunately, because of the limited discourse in the orthopaedic literature, there are few guidelines regarding the treatment for these injuries. This study analyzes the treatment of 16 anterior tibialis tendon ruptures. Eight patients in this group had operative treatment of their ruptures, and eight patients had nonsurgical treatment of their ruptures. The average follow-up for the operative and nonoperative patients were 6.68 years and 3.86 years, respectively. The Foot and Ankle Outcome questionnaire provided by the American Academy of Orthopaedic Surgeons and an outcome-based foot score described by Kitaoka et al. were used as the methods of analysis. Our outcome results show no statistically significant difference between operative and nonoperative treatment in anterior tibialis tendon ruptures. The lack of statistical difference between operative and nonoperative groups may be a reflection of the age bimodality present in this study. Elderly low demand patients were treated nonsurgically and young active patients were treated operatively. Therefore, despite a lack of statistical difference present in the outcome of both groups, we still maintain the need to repair/reconstruct anterior tibialis tendon ruptures in young active patients with high functional demands. The deficits present in the nonoperative group, we believe, would not be well tolerated in a young high functional demand patient. Nonsurgical management is an appropriate alternative in low demand elderly patients.

Từ khóa


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