• 1.

    Zwipp H, Dahlen C, Amlang M, et al: Verletzungen der sehne des M. tibialis posterior. Orthopäde 29: 251, 2000.

  • 2.

    Myerson MS, Badekas A, Schon LC: Treatment of stage II posterior tibial tendon deficiency with flexor digitorum longus tendon transfer and calcaneal osteotomy. Foot Ankle Int 25: 445, 2004.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Kohls-Gatzoulis J, Angel JC, Singh D, et al: Tibialis posterior dysfunction: a common and treatable cause of adult acquired flatfoot. BMJ 329: 1328, 2004.

  • 4.

    Johnson KA, Strom DE: Tibialis posterior tendon dysfunction. Clin Orthop Relat Res 239: 196, 1989.

  • 5.

    Funk DA, Cass JR, Johnson KA: Acquired adult flat foot secondary to posterior tibial tendon pathology. J Bone Joint Surg Am 68: 95, 1986.

  • 6.

    Gluck GS, Heckman DS, Parekh SG: Tendon disorders of the foot and ankle, part 3: the posterior tibialis tendon. Am J Sports Med 38: 2133, 2010.

  • 7.

    West MA, 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 49: 565, 2010.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 8.

    Mann RA, Thompson FM: Rupture of the posterior tibial tendon causing flat foot. Surgical treatment. J Bone Joint Surg 67: 556, 1985.

  • 9.

    Hintermann B, Gächter A: The first metatarsal rise sign: a simple, sensitive sign of tibialis posterior tendon dysfunction. Foot Ankle Int 17: 236, 1996.

  • 10.

    Holmes GB, Mann RA: Possible epidemiological factors associated with rupture of the posterior tibial tendon. Foot Ankle 13: 70, 1992.

  • 11.

    Mendicino SS: Posterior tibial tendon dysfunction. Diagnosis, evaluation and treatment. Clin Podiatr Med Surg 17: 33, 2000.

  • 12.

    Tallon C, Maffulli N, Ewen SW: Ruptured Achilles tendons are significantly more degenerated than tendinopathic tendons. Med Sci Sports Exerc 33: 1983, 2001.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Jones GC, Corps AN, Pennington CJ, et al: Expression profiling of metalloproteinases and tissue inhibitors of metalloproteinases in normal and degenerate human achilles tendon. Arthritis Rheum 54: 832, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Kannus P, Józsa L: Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 73: 1507, 1991.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Corps AN, Robinson AH, Harrall RL, et al: Changes in matrix protein biochemistry and the expression of mRNA encoding matrix proteins and metalloproteinases in posterior tibialis tendinopathy. Ann Rheum Dis 71: 746, 2012.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 16.

    Harner O, Lindholm A: Subcutaneous rupture of the Achilles tendon; a study of 92 cases. Acta Chir Scand Suppl 116: 1, 1959.

  • 17.

    Foster AP, Thompson NW, Crone MD, et al: Rupture of the tibialis posterior tendon: an important differential in the assessment of ankle injuries. Emerg Med J 22: 915, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Acute Rupture of the Tibialis Posterior Tendon without Fracture

A Case Report

Nicolò Martinelli Istituto di Ricerca e Cura a Carattere (IRCCS) Galeazzi, Ankle and Foot Surgery, Milan, Italy.

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Carlo Bonifacini Istituto di Ricerca e Cura a Carattere (IRCCS) Galeazzi, Ankle and Foot Surgery, Milan, Italy.

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Alberto Bianchi Istituto di Ricerca e Cura a Carattere (IRCCS) Galeazzi, Ankle and Foot Surgery, Milan, Italy.

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Laura Moneghini Department of Pathology, San Paolo Hospital, Milan, Italy.

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Gennaro Scotto Istituto di Ricerca e Cura a Carattere (IRCCS) Galeazzi, Ankle and Foot Surgery, Milan, Italy.

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Elena Sartorelli Istituto di Ricerca e Cura a Carattere (IRCCS) Galeazzi, Ankle and Foot Surgery, Milan, Italy.

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The acute rupture of the tibialis posterior (TP) tendon, compared to an acute rupture of the Achilles tendon, is a quite uncommon disease to be diagnosed in the emergency department setting. In most cases symptoms related to a TP dysfunction, like weakness, pain along the course of the tendon, swelling in the region of the medial malleolus, and the partial or complete loss of the medial arch with a flatfoot deformity precede the complete rupture of the tendon. In this case report, we describe an acute rupture of the TP tendon following a pronation-external rotation injury of the ankle with no association of a medial malleolus fracture and with no history of a prior flatfoot deformity or symptoms.

Corresponding author: Nicolò Martinelli, MD, IRCCS Galeazzi, Ankle and Foot Surgery, via R. Galeazzi 4 Milan, 20100 Italy. (E-mail: n.martinelli@unicampus.it)
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