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Anterior Tibial Tendon Rupture

Anatomy
The anterior tibial tendon runs along the front of the ankle. It connects the muscle in the lateral front of the calf that pulls the ankle upward. The tendon inserts into the top of the midfoot on the inside (medial side).

Injury
When the anterior tibial tendon has been injured a “foot drop” may develop. That means that you will have weakness bringing your foot up, and it will slap down when you walk. There are several muscles that pull the toes up, and they also help bring the ankle up. But they are weaker than the anterior tibial muscle.

The anterior tibial tendon usually ruptures acutely, with no preceeding sense of pain about it. Older patients are most at risk for this injury. When it ruptures there will be pain at the front of the ankle, and you may be able to feel a bump or ball of tissue by the front of the ankle or just above it. That ball of tissue is the tendon that has torn from the arch of the foot and retracted up to the front of the ankle.

Evaluation
Anterior tibial tendon rupture is usually obvious on the physical examination. Weakness in ankle dorsiflexion and a palpable defect in the tendon can often confirm the suspicion based on the history. An MRI test is excellent to identify this tendon rupture.

Treatment
Treatment options for this problem include protecting it with a Brace, using oral anti-inflammatory medications to relieve pain, or having surgery to repair the tendon.

 


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