Rupture of the anterior tibialis tendon: A review of the literature and case study of reconstruction with semitendinosus tendon in a patient with diabetes mellitus and polyneuropathy

Abstract : Background: Rupture of the tibialis anterior tendon is a rare injury. It can be traumatic or spontaneous. Spontaneous rupture is usually a consequence of degenerative changes of the tendon caused by accompanied diseases. For successful treatment and rehabilitation early diagnosis is mandatory. For diagnosis a clinical examination is most important and ultrasound examination and/or magnetic resonance additionally confirms the diagnosis. Treatment can be operative or conservative with below knee non-weight bearing cast. Conservative treatment is usually decided where ruptures are older than three months, especially in patients with poorer mobility or with accompanied diseases. In the literature there are several techniques considering surgical treatment. Case report: A 56 years old men with diabetes mellitus and polyneuropathy sustained a rupture of the tibialis anterior tendon at injury walking downhill. Rupture was at first unrecognized and was treated as an ankle sprain.  After two months he was reexamined and a rupture of the tibialis anterior tendon was diagnosed and surgically reconstructed using semitendinosus tendon graft. Conclusion: Rupture of the anterior tendon of tibialis muscle was reconstructed by using an autologous graft of semitendinosus muscle tendon, in which we achieved good long-term results. Tendon of semitendinosus is suitable because it has properties similar to anterior tendon of tibialis muscle. Because of the similar diameters it is also suitable for bridging of longer defects, such as in our case.