Combined rupture of the tibialis anterior and the extensor hallucis longus tendons--functional reconstruction

Traumatic rupture of the tibialis anterior (TA) tendon represents a very rare foot injury. A combined injury of both the TA and the extensor hallucis longus (EHL) tendons has not yet been reported. Within the scope of this work we will prove that tendon transfers in cases of combined tendon injuries are a reasonable course of action in order to achieve the aim of a functional reconstruction.

A combined rupture of the tibialis anterior (TA) and the extensor hallucis longus (EHL) tendons was treated by suturing the EHL tendon to the distal TA tendon stump. The TA insertion was secured and the distal portion of the EHL tendon attached to an extensor digitorum slip. The TA muscle was proximally attached to the tendinous EHL segment.

A 1 year follow-up verified very good results, showing the patient without complaints in regard to the trauma. Compared with the contralateral non-affected side, the repaired foot showed very satisfactory results in reference to range of motion, strength and gait.

With this work we proved that tendon transfers in cases of combined tendon injuries make sense in order to achieve functional reconstruction. This approach preserves function and strength and avoids the problems and risks of alternate treatment techniques, including tendon grafting.