Wardell Richard M, Hanselman Andrew E, Daffner Scott D, Santrock Robert D
Robert C. Byrd Health Sciences Center, West Virginia University School of Medicine, Morgantown, West Virginia.
Foot Ankle Spec. 2017 Dec;10(6):572-577. doi: 10.1177/1938640017704945. Epub 2017 Apr 25.
Ankle fractures with an associated posterior tibialis tendon (PTT) rupture are rare injuries and have only been described in a number of case reports. These prior reports include patients that had an open fracture and/or an associated medial malleolar fracture component. In this unique case report, we present a patient that sustained a closed bimalleolar-equivalent ankle fracture/dislocation without medial malleolar involvement which was irreducible due to a PTT rupture and subsequent distal segment interposition in the tibiotalar joint. Identification of acute PTT rupture with associated ankle fracture is important because early repair is associated with significantly better functional outcomes compared with late repair. These injury patterns may easily be missed due to the limitations with physical examination and standard imaging often encountered during initial evaluation of routine ankle fractures. Therefore, physicians should maintain a high level of suspicion in the appropriate clinical setting in order to provide appropriate diagnosis and timely surgical intervention.
Descriptive, Level V: Single case report.
伴有胫后肌腱（PTT）断裂的踝关节骨折是罕见损伤，仅在一些病例报告中有描述。这些既往报告包括有开放性骨折和/或伴有内踝骨折成分的患者。在本独特病例报告中，我们呈现了一名患者，其遭受了相当于双踝的闭合性踝关节骨折/脱位，无内踝受累，由于PTT断裂及随后距骨远端在胫距关节内的嵌入而无法复位。识别伴有踝关节骨折的急性PTT断裂很重要，因为与延迟修复相比，早期修复与显著更好的功能结局相关。由于在常规踝关节骨折初始评估中经常遇到的体格检查和标准影像学的局限性，这些损伤模式可能很容易被漏诊。因此，医生在适当的临床环境中应保持高度怀疑，以便进行适当的诊断和及时的手术干预。
描述性，V级：单病例报告。
