Traumatic extensor tendons injuries of the foot in childhood: a case report

Main Article Content

Alessio Pedrazzini
Pier Giulio Valenti
Nicola Bertoni
Bianca Pedrabissi
Henry Yewo Simo
Roberto Bisaschi
Vanni Medina
Francesco Ceccarelli
Francesco Pogliacomi

Keywords

extensor tendons, foot, children, injury, rupture

Abstract

Background and aim of the work: Extensor tendon injuries of the foot in children represent a rare foot injury. We report a case of a 9 year-old male who suffered of a traumatic wound laceration in the distal third of the right leg with a glass the day before in another country, getting a combined injury of tibialis anterior (TA), extensor hallucis longus (EHL) and extensor digitorum longus (EDL). Methods: After an initial clinical and radiological evaluation, antibiotic prophylaxis was immediately started. Surgery was necessary for the repair of the lesions and after rehabilitation the patient recovered a good function with a complete return to a normal life. Results: 5 years follow-up clinical examination revealed a complete and painless range of movement comparable to the other foot. The patient regained active dorsiflexion without functional limitations, deformity or contracture. Conclusions: Early exploration is important to allow full definition of the extent of injury and early surgical repair of tendons is recommended to avoid future disability.

Abstract 392 | PDF Downloads 608

References

1. Sammarco VJ, Sammarco GJ. Injuries to the Tibialis Anterior, Peroneal Tendons, and Long Flexors of the Toes. Baxter's the Foot and Ankle in Sport 2008; 2nd ed: 121-46.
2 Gwynne-Jones D, Garneti N, Wyatt M. Closed tibialis anterior tendon rupture: a case series. Foot & Ankle International 2009; 30: 758-62.
3 Lee MH, Chung CB, Cho JH. et al. Tibialis anterior tendon and extensor retinaculum: imaging in cadavers and patients with tendon tear. American Journal of Roentgenology 2006; 187: 161-68.
4 Wong JC, Daniel JN, Raikin SM. Repair of acute extensor hallucis longus tendon injuries: a retrospective review. Foot & Ankle Specialist 2013; 7: 45-51.
5 Pedrazzini A, Ceccarelli F, Martelli A et al. Return to run after partial amputation of the ankle: clinical assessment and instrumental evaluation. Acta Biomedica 2013; 84: 237-43.
6. Al-Qattan MM. Surgical treatment and results in 17 cases of open lacerations of the extensor hallucis longus tendon. J Plast Reconstr Aesthet Surg 2007; 60: 360-37.
7 Jackson RH. Laceration from glass in childhood. Br Med J (Clin Res Ed) 1981; 283: 1310-312.
8. Griffiths JC. Tendon injuries around the ankle. The journal of bone and joint surgery 1965; 47B: 686-89.
9. Wicks MH, Paterson DC. Tendon Injuries about the foot and ankle in children. Australian and New Zealand Journal of Surgery 1980; 50: 158-61.
10 Markarian GG, Kelikian AS, Brage M, Trainor T, Dias L. Anterior tibialis tendon ruptures: an outcome analysis of operative versus nonoperative treatment. Foot & Ankle International 1998; 19: 792-02.
11. Dooley BJ, Kudelka P, Menelaus MB. Subcutaneous rupture of the tendon of tibialis anterior. J Bone Joint Surg Br. 1980; 62b: 471–72.
12 Forst R, Forst J, Heller KD. Ipsilateral peroneus brevis tendon grafting in a complicated case of traumatic rupture of tibialis anterior tendon. Foot Ankle Int. 1995; 16: 440–44.
13 Tuncer S, Aksu N, Isiklar Ugur. Delayed rupture of the extensor hallucis longus and extensor digitorum communis tendons after breaching the anterior capsule with a radiofrequency probe during ankle arthroscopy: a case report. The Journal of Foot and Ankle Surgery 2010; 49: 490.e1-90.e3.
14. Waizy H, Bouillon B, Stukenborg-Colsman C et al. Ruptur der Musculus tibialis anterior Sehne. Der Unfallchirurg 2017; 120: 1015–19.
15. Bianchi S, Zwass A, Abdelwahab IF et al. Evaluation of tibialis anterior tendon rupture by ultrasonography. J Clin Ultrasound 1994; 22: 564–66.
16. Din R, Therkilsden L. Rupture of tibilais anterior associated with a closed midshaft tibial fracture. J Accid Emerg Med. 1999; 16: 459.
17. So E, Black TE, Mehl B. Split peroneus longus free tendon autograft transplantation for the treatment of neglected extensor hallucis longus tendon laceration: a case report. The Journal of Foot and Ankle Surgery 2018; 57: 210-14.
18. Lefebvre B, Beldame J, Bertiaux S, Biga N. Open and subcutaneous recent tibialis anterior tendon ruptures: does postoperative immobilization method influence outcome? Orthopaedics & Traumatology: Surgery & Research 2011; 97: 211—16.