Extensor hallucis longus-transfer for tibialis anterior tendon rupture repair

Restore the function of the tibialis anterior muscle, which is responsible for dorsiflexion and inversion of the foot.

Spontaneous or traumatic rupture of the tibialis anterior tendon.

Patients with multimorbidity or lack of functional demands.

Direct repair of the tibialis anterior tendon with fiber-wire suture and augmentation with extensor hallucis longus tendon, potentially in combination with reinsertion of the tibialis anterior tendon in the medial cuneiform.

Six weeks of non-weight-bearing: 3 weeks of cast immobilization with ankle in 10° dorsiflexion, followed by 3 weeks of splint immobilization and passive mobilization. Then stepwise increase in weight-bearing over a period of 2-3 weeks.

In 8 patients postoperative results with a mean follow-up of 13.5 months were available. One patient showed a rerupture of the augmented tendon. The mean American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 81.0 (range 67-88). The median ankle dorsiflexion muscle strength was 67% (range 29.3-85.5%) compared to the nonoperated leg. All patients, except the one that experienced rerupture, were very satisfied or satisfied with the result.