Fraissler L, Horas K, Bölch S, Raab P, Rudert M, Walcher M
Klinik Diakonissen Schladming, Salzburger Straße 777, 8970, Schladming, Austria.
Orthopädische Klinik König-Ludwig-Haus, Lehrstuhl für Orthopädie, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Germany.
Oper Orthop Traumatol. 2019 Apr;31(2):143-148. doi: 10.1007/s00064-018-0571-7. Epub 2018 Oct 9.
Restore the function of the tibialis anterior muscle, which is responsible for dorsiflexion and inversion of the foot.
Spontaneous or traumatic rupture of the tibialis anterior tendon.
Patients with multimorbidity or lack of functional demands.
Direct repair of the tibialis anterior tendon with fiber-wire suture and augmentation with extensor hallucis longus tendon, potentially in combination with reinsertion of the tibialis anterior tendon in the medial cuneiform.
Six weeks of non-weight-bearing: 3 weeks of cast immobilization with ankle in 10° dorsiflexion, followed by 3 weeks of splint immobilization and passive mobilization. Then stepwise increase in weight-bearing over a period of 2-3 weeks.
In 8 patients postoperative results with a mean follow-up of 13.5 months were available. One patient showed a rerupture of the augmented tendon. The mean American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 81.0 (range 67-88). The median ankle dorsiflexion muscle strength was 67% (range 29.3-85.5%) compared to the nonoperated leg. All patients, except the one that experienced rerupture, were very satisfied or satisfied with the result.
恢复负责足背屈和内翻的胫骨前肌的功能。
胫骨前肌腱自发性或外伤性断裂。
患有多种疾病或功能需求不足的患者。
用纤维线缝合直接修复胫骨前肌腱，并用拇长伸肌腱加强，可能结合胫骨前肌腱在内侧楔骨的重新附着。
六周不负重：3周用石膏固定，踝关节背屈10°，随后3周用夹板固定并进行被动活动。然后在2至3周内逐步增加负重。
8例患者有术后结果，平均随访13.5个月。1例患者出现加强肌腱再次断裂。美国矫形足踝协会（AOFAS）后足平均评分为81.0（范围67 - 88）。与未手术侧相比，踝关节背屈肌力量中位数为67%（范围29.3 - 85.5%）。除了经历再次断裂的那例患者外，所有患者对结果非常满意或满意。
