Avulsion Fracture of the Tibialis Anterior Tendon Associated with First Metatarsal Base Fracture: A Case Report and Literature Review

Document Type : CASE REPORT

Authors

1 1 Department of Orthopaedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, China 2 Department of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 3 Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

2 Department of Orthopaedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, China

3 2 Department of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 3 Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

10.22038/abjs.2023.74692.3457

Abstract

We present a unique case of a 59-year-old shipyard worker who sustained an avulsion fracture of the 
tibialis anterior tendon, concurrently with a comminuted fracture at the base of the first metatarsal. This 
is the first reported case highlighting this concomitant presentation, which underlines the possibility of 
avulsion fractures accompanying comminuted fractures. Importantly, such avulsion fractures could lead 
to skin tenting and potential necrosis, necessitating early identification and prompt intervent ion. The 
patient underwent successful surgical intervention and displayed good functional restoration 15 months 
postoperatively.
 Level of evidence: IV

Graphical Abstract

Avulsion Fracture of the Tibialis Anterior Tendon Associated with First Metatarsal Base Fracture: A Case Report and Literature Review

Keywords

Main Subjects


  1. Constantinou M, Wilson A. Traumatic tear of tibialis anterior during a Gaelic football game: a case report. Br J Sports Med. 2004; 38(6):e30. doi: 10.1136/bjsm.2003.007625.
  2. 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(5):463-7. doi: 10.1053/j.jfas.2008.05.007.
  3. Machani B, Narayan B, Casserly HB. Closed avulsion of the Tibialis Anterior: an unusual cause of compartment syndrome. Injury.2000; 31(9):738-9. doi: 10.1016/s0020-1383(00)00095-4.
  4. Rajeev A, McDonald M, Newby M, Patterson P. Traumatic avulsion of tibialis anterior following an industrial accident: A case report. Int J Surg Case Rep. 2015:14:125-8. doi: 10.1016/j.ijscr.2015.06.043.
  5. Jerome JTJ, Varghese M, Sankaran B, Thirumagal KJTF, Journal AO. Tibialis Anterior Rupture: A missed diagnosis. The Foot and Ankle Online Journal. 2010; 3(9). doi: 10.3827/faoj.2010.0309.0002.
  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(12):792-802. doi: 10.1177/107110079801901202.
  7. Kwak H-Y, Bae S-W. Isolated Avulsion Fracture at the Plantar Lateral Base of the First Metatarsal: A Case Report. Foot Ankle Int.2000 Oct; 21(10):864-7. doi: 10.1177/107110070002101013.
  8. Murakami T, Okamura K, Harada S, et al. Avulsion fracture of peroneus longus at the first metatarsal insertion: a case report. Br J Sports Med.2004; 38(4):E13. doi: 10.1136/bjsm.2003.008144.