Tibialis Anterior Tendon Reconstruction Utilizing Split Tendon Turn-down: A Case Report and Technique Guide

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research
• Regenerative Medicine

Background:

• Tibialis anterior tendon (TAT) ruptures are infrequent, accounting for <1% of all tendon injuries.
• Ruptures can be acute or atraumatic, often linked to chronic tendinopathy, necessitating surgical intervention when conservative methods fail.
• Direct end-to-end repair is standard but challenging for large TAT defects, prompting exploration of alternative techniques.

Purpose of the Study:

• To present a unique surgical technique for managing large-deficit, chronic tibialis anterior tendon ruptures.
• To evaluate the efficacy of a minimal-incision TAT turn-down with dermal matrix allograft augmentation.
• To report outcomes in a patient with a large insertional TAT defect using this novel method.

Main Methods:

• A novel surgical technique involving a minimal-incision split tibialis anterior tendon (TAT) turn-down.
• Augmentation of the repaired tendon with a dermal matrix allograft.
• Application of the technique in a case study of a patient with a large insertional TAT defect.

Main Results:

• The patient experienced favorable postoperative outcomes, including reduced pain and improved satisfaction.
• Significant improvements were observed in functional scores and lower extremity strength.
• The technique demonstrated versatility for varying tendon defect sizes and suitability for patients with comorbidities.

Conclusions:

• The split TAT turn-down technique with dermal matrix allograft augmentation presents a viable alternative for large-deficit TAT ruptures.
• This minimal-incision approach offers a promising solution when direct end-to-end repair is not feasible.
• The technique shows potential for successful management of complex tibialis anterior tendon injuries.