Augusto Roca Fernández, Rajul Gupta, Brian Johnson, Richard M. Smith, Richard T. Laughlin
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Reconstruction of the Anterior Tibialis Tendon Using In-phase Tendon Transfers
Anterior tibialis tendon ruptures or lacerations are rare conditions that do not have a universally accepted treatment. Previously reported methods have described end-to-end repair, transfer of the extensor hallucis longus, and allograft interposition graft. The purpose of this paper is to describe a technique for reconstruction of the anterior tibialis tendon with a transfer of the medial 2 tendons of the extensor digitorum longus (EDL) to span any gaps or diseased tendon. In addition, the lateral 2 tendons of the EDL are transferred to the peroneus tertius to balance dorsiflexion and prevent overpull on the fourth and fifth toes if the EDL tendons are left in place. Using the EDL to reconstruct the anterior tibialis provides an in-phase tendon transfer resulting in symmetric dorsiflexion at the ankle. In addition, the EDL is a normal muscle with the capacity for hypertrophy, which supplements the muscle power of the injured anterior tibialis which often atrophies in the interim between injury and repair. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍:
Techniques in Foot & Ankle Surgery offers a unique opportunity to master the most innovative and successful surgical techniques for correction of foot and ankle disorders. Featuring contributions from the world"s foremost orthopaedic surgeons and podiatrists, this quarterly journal supplies step-by-step details on these techniques. The contributors explain the rationale, indications, and contraindications for each procedure, identify the pitfalls and potential complications, and provide invaluable tips for improving results. The journal is illustrated cover to cover with intraoperative photographs and drawings, including several in full color.