West Malcolm A, Sangani Chetan, Toh Eugene
Department of Trauma and Orthopaedics, Southport and Ormskirk NHS Hospital Trust, Southport, UK.
J Foot Ankle Surg. 2010 Nov-Dec;49(6):565.e9-12. doi: 10.1053/j.jfas.2010.07.011. Epub 2010 Sep 9.
We report an acute rupture of a macroscopically normal tibialis posterior tendon in the setting of an acute closed ankle fracture. This injury is considered to be rare, although it is probably frequently overlooked preoperatively because of limitations of the clinical examination secondary to pain. The tibialis posterior tendon rupture was identified at the time of operative repair of the ankle fracture, and direct suture repair of the tendon was undertaken. After primary suture and osteosynthesis, the patient's progress was favorable and a satisfactory outcome was achieved. A clear history of the mechanism of injury as well as a high index of suspicion should be maintained, because failure to repair rupture of the tibialis posterior tendon, in the presence of an ankle fracture, is likely to lead to long-term patient disability and a planovalgus foot.
我们报告了一例在急性闭合性踝关节骨折情况下，肉眼看似正常的胫后肌腱急性断裂。尽管由于疼痛导致临床检查受限，术前可能经常被忽视，但这种损伤被认为是罕见的。胫后肌腱断裂是在踝关节骨折手术修复时发现的，并对肌腱进行了直接缝合修复。一期缝合和骨固定后，患者恢复良好，取得了满意的结果。应明确损伤机制的病史并保持高度怀疑，因为在存在踝关节骨折的情况下，未能修复胫后肌腱断裂可能会导致患者长期残疾和扁平外翻足。
