Journal List > J Korean Orthop Assoc > v.50(5) > 1013403

TOOLS
Kweon, Kang, and Lee: Complete Rupture of the Tibialis Anterior Tendon Due to Intratendinous Ganglion Cyst
Case Report

Journal of the Korean Orthopaedic Association 2015; 50(5): 412-417.

Published online: 23 October 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.5.412

Complete Rupture of the Tibialis Anterior Tendon Due to Intratendinous Ganglion Cyst

Seok Hyun Kweon, M.D., Ph.D., Hong Je Kang, M.D., Ph.D., Seoung In Lee, M.D.

Department of Orthopaedic Surgery, Wonkwang University School of Medicine, Iksan, Korea.

Correspondence to: Hong Je Kang, M.D., Ph.D. Department of Orthopaedic Surgery, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea. TEL: +82-63-859-1360, FAX: +82-63-852-9329, kanghongje@hanmail.net

Received 28 March 2014       Revised 24 April 2014       Accepted 16 May 2015

Copyright © 2015 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spontaneous rupture of the tibialis anterior tendon is rare among ordinary people. The tendon rupture usually occurs in patients iatrogenically after local steroid injection to the tendon or with pre-existing systemic disease such as diabetes mellitus, gout, and rheumatic disease. However, no case of complete rupture of the tibialis anterior tendon due to an intratendinous ganglion cyst has been reported. We report on a case of a 39-year-old female with spontaneous rupture of the tibialis anterior tendon due to intratendinous ganglion cyst and her clinical results.

Keywords: anterior tibial tendon, ganglion cyst, spontaneous rupture

Figures and Tables

Figure 1

Photograph showing mild erythematous skin color change and swelling just anterior of the tibialis anterior tendon.

jkoa-50-412-g001
Figure 2

Magnetic resonance imaging showing the cystic lesion located along the tibialis anterior tendon. Low signaled in T1-weighted image (A, B) and high signaled in T2-weighted image. (C, D) Continuity of tibialis anterior tendon near the cystic lesion was not seen, suggesting complete rupture.

jkoa-50-412-g002
Figure 3

Intraoperative photograph illustrating the deep purple, well demarcated 8×5-cm-sized soft tissue mass.

jkoa-50-412-g003
Figure 4

After incision of the cystic wall, we observed a completely ruptured tibialis anterior tendon. And severe delaminated and degenerative changes were observed on the proximal and distal end of the ruptured tendon.

jkoa-50-412-g004
Figure 5

The distal portion of the ruptured tibialis anterior tendon was sutured to the side of the intact extensor hallucis longus tendon.

jkoa-50-412-g005
Figure 6

Photomicrograph demonstrates hyalinized collagenous fibrous wall and a characteristic myxoid degeneration (H&E; A: ×40, B: ×100). These are specific findings of ganglion.

jkoa-50-412-g006
Figure 7

Active dorsal ankle flexion at 30 months.

jkoa-50-412-g007

Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

References

1. Jerome JT, Varghese M, Sankaran B, Thomas S, Thirumagal SK. Tibialis anterior tendon rupture in gout--case report and literature review. Foot Ankle Surg. 2008; 14:166–169.
2. Sapkas GS, Tzoutzopoulos A, Tsoukas FC, Triantafillopoulos IK. Spontaneous tibialis anterior tendon rupture: delayed repair with free-sliding tibialis anterior tendon graft. Am J Orthop (Belle Mead NJ). 2008; 37:E213–E216.
3. Khoury NJ, el-Khoury GY, Saltzman CL, Brandser EA. Rupture of the anterior tibial tendon: diagnosis by MR imaging. AJR Am J Roentgenol. 1996; 167:351–354.
4. DiDomenico LA, Williams K, Petrolla AF. Spontaneous rupture of the anterior tibial tendon in a diabetic patient: results of operative treatment. J Foot Ankle Surg. 2008; 47:463–467.
5. Aydingöz U, Aydingöz O. Spontaneous rupture of the tibialis anterior tendon in a patient with psoriasis. Clin Imaging. 2002; 26:209–211.
6. Markarian GG, Kelikian AS, Brage M, Trainor T, Dias L. Anterior tibialis tendon ruptures: an outcome analysis of operative versus nonoperative treatment. Foot Ankle Int. 1998; 19:792–802.
7. Waldecker U. Unusual location of a posttraumatic ganglion and rupture of the peroneus brevis tendon: a case report. J Foot Ankle Surg. 2005; 44:163–165.
8. Petersen W, Stein V, Tillmann B. Blood supply of the tibialis anterior tendon. Arch Orthop Trauma Surg. 1999; 119:371–375.
9. Sammarco VJ, Sammarco GJ, Henning C, Chaim S. Surgical repair of acute and chronic tibialis anterior tendon ruptures. J Bone Joint Surg Am. 2009; 91:325–332.
TOOLS
Similar articles