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Unique Case of Posterior Tibial Tendon Dysfunction After Stingray Strike
Dustin Hambright1, Daniel Guss1, Jeremy T Smith2
1Department of Orthopaedics, Brigham and Women's Hospital, Boston, Massachusetts.
Foot & Ankle Specialist
|June 27, 2015
Summary
A stingray injury directly impacting the posterior tibial tendon caused acquired adult flatfoot deformity in a 69-year-old male. Early irrigation and debridement of such tendon injuries may prevent progressive dysfunction.
Area of Science:
- Orthopedic surgery
- Podiatry
- Traumatology
Background:
- Posterior tibial tendon dysfunction (PTTD) is a frequent cause of adult acquired flatfoot deformity.
- Causes of PTTD include microtrauma, compromised blood supply, and tendon rupture.
Observation:
- A 69-year-old male developed PTTD and acquired flatfoot deformity after a stingray injury directly to the posterior tibial tendon.
- Surgical evaluation revealed severe degeneration of the tendon at the penetration site.
Findings:
- This is the first reported case of stingray envenomation directly affecting a tendon, leading to dysfunction.
- Stingray injuries typically involve skin penetration and inflammation, but direct tendon trauma is unprecedented.
Implications:
- Thousands of stingray injuries occur annually in the US, with varying severity.
- Prompt irrigation and debridement for direct tendon penetration injuries may mitigate long-term functional deficits and PTTD.
