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

Seok Hyun Kweon; Hong Je Kang; Seoung In Lee

doi:10.4055/jkoa.2015.50.5.412

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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

(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.

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.

Figure 3

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

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.

Figure 5

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

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.

Figure 7

Active dorsal ankle flexion at 30 months.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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