Advertisement

Interposition of Tibialis Posterior and Flexor Digitorum Longus Tendons Resulted in Irreducible Ankle Fracture-Dislocation

  • Amir Reza Vosoughi
    Correspondence
    Address correspondence to: Amir Reza Vosoughi, MD, Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz 71948-15644, Iran.
    Affiliations
    Assistant Professor, Foot and Ankle Surgeon, Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
    Search for articles by this author
  • Mark Glazebrook
    Affiliations
    Professor of Surgery, Orthopedic Foot & Ankle and Sports Medicine, Dalhousie University & Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada
    Search for articles by this author

      Abstract

      Irreducible ankle fracture-dislocations are very rare entities. The present case report demonstrates an unusual finding of tibialis posterior and flexor digitorum longus tendons interposed in the tibiofibular joint impairing successful closed reduction of ankle fracture-dislocation. A 45-year-old patient presented with a bimalleolar pronation-external rotation ankle fracture-dislocation after a motorcycle accident. Attempts to perform closed reduction before surgery were unsuccessful. Subsequent urgent open reduction and internal fixation surgical management revealed interposition of the tibialis posterior and flexor digitorum longus tendons in the tibiofibular joint. In irreducible fracture-dislocation of the ankle with severe lateral displacement of the talus, one should be aware of the possibility of soft tissue interposition of the tibialis posterior and flexor digitorum longus tendons in the tibiofibular joint.

      Level of Clinical Evidence

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Thur C.K.
        • Edgren G.
        • Jansson K.Å.
        • Wretenberg P.
        Epidemiology of adult ankle fractures in Sweden between 1987 and 2004: a population-based study of 91,410 Swedish inpatients.
        Acta Orthop. 2012; 83: 276-281
        • Hindle P.
        • Davidson E.K.
        • Biant L.C.
        • Court-Brown C.M.
        Appendicular joint dislocations.
        Injury. 2013; 44: 1022-1027
        • Ellanti P.
        • Hammad Y.
        • Grieve P.P.
        Acutely irreducible ankle fracture dislocation: a report of a Bosworth fracture and its management.
        J Emerg Med. 2013; 44: e349-e352
        • Peterson N.D.
        • Shah F.
        • Narayan B.
        An unusual ankle injury: the Bosworth-pilon fracture.
        J Foot Ankle Surg. 2015; 54: 751-753
        • Schatzker J.
        • Johnson R.G.
        Fracture-dislocation of the ankle with anterior dislocation of the fibula.
        J Trauma. 1983; 23: 420-423
        • Hsiao K.C.
        • Tu C.H.
        Irreducible fracture dislocation of the ankle: report of two cases.
        J Formos Med Assoc. 1994; 93: S161-S165
        • Böhler L.
        The Treatment of Fractures.
        William Wood, Baltimore, MD1936: 453
        • Parrish T.F.
        Fracture-dislocation of the ankle: an unusual cause of failure of reduction: a case report.
        J Bone Joint Surg Am. 1959; 41: 749-751
        • Walker R.H.
        • Farris C.
        Irreducible fracture-dislocations of the ankle associated with interposition of the tibialis posterior tendon: case report and review of the literature of a specific ankle fracture syndrome.
        Clin Orthop Relat Res. 1981; 160: 212-216
        • Anderson J.G.
        • Hansen S.T.
        Fracture-dislocation of the ankle with posterior tibial tendon entrapment within the tibiofibular interosseous space: a case report of a late diagnosis.
        Foot Ankle Int. 1996; 17: 114-118
        • Ermis M.N.
        • Yagmurlu M.F.
        • Kilinc A.S.
        • Karakas E.S.
        Irreducible fracture dislocation of the ankle caused by tibialis posterior tendon interposition.
        J Foot Ankle Surg. 2010; 49: 166-171
        • Lacasse J.S.
        • Laflamme M.
        • Penner M.J.
        Irreducible fracture-dislocation of the ankle associated with interposition of the tibialis posterior tendon in the syndesmosis: a case report.
        J Foot Ankle Surg. 2015; 54: 962-966
        • Connors J.C.
        • Coyer M.A.
        • Hardy M.A.
        Irreducible ankle fracture dislocation due to tibialis posterior tendon interposition: a case report.
        J Foot Ankle Surg. 2016; 55: 1276-1281
        • Trividi M.
        • Brown E.
        • Lese A.
        • Katz L.D.
        Lateral dislocation and incarceration of the posterior tibial tendon through the distal tibiofibular syndesmosis.
        Skeletal Radiol. 2014; 43: 1175-1178
        • Natoli R.M.
        • Summers H.D.
        Irreducible ankle fracture-dislocation due to tibialis anterior subluxation: a case report.
        J Foot Ankle Surg. 2015; 54: 268-272
        • Ortolani A.
        • Bevoni R.
        • Russo A.
        • Marcacci M.
        • Girolami M.
        Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review.
        Joints. 2016; 4: 183-188
        • Pankovich A.M.
        Fracture-dislocation of the ankle: trapping of the postero-medical ankle tendons and neurovascular bundle in the tibiofibular interosseous space: a case report.
        J Trauma. 1976; 16: 927-929
        • Coonrad R.W.
        • Bugg Jr., E.I.
        Trapping of the posterior tibial tendon and interposition of soft tissue in severe fractures about the ankle joint.
        J Bone Joint Surg Am. 1954; 36: 744-750
        • Hunter A.M.
        • Bowlin C.
        Posterior tibial tendon entrapment within an intact ankle mortise: a case report.
        J Foot Ankle Surg. 2015; 54: 116-119
        • Formica M.
        • Santolini F.
        • Alessio-Mazzola M.
        • Repetto I.
        • Andretta A.
        • Stella M.
        Closed medial malleolar multifragment fracture with a posterior tibialis tendon rupture: a case report and review of the literature.
        J Foot Ankle Surg. 2016; 55: 832-837
        • West M.A.
        • Sangani C.
        • Toh E.
        Tibialis posterior tendon rupture associated with a closed medial malleolar fracture: a case report and review of the literature.
        J Foot Ankle Surg. 2010; 49: 565.e9-565.e12