Τετάρτη 13 Σεπτεμβρίου 2017

Proximal avulsion rupture of the flexor digitorum longus tendon associated with a medial malleolus ankle fracture

Description

A 37-year-old man presented to the emergency department with right lower limb pain after being hit by an excavator. His right ankle was swollen, but no open wounds were observed. Radiography and CT of the right ankle revealed a medial malleolus ankle fracture (figure 1A,B).

Figure 1

(A) Radiograph revealing a medial malleolus ankle fracture. (B) CT scan revealing a medial malleolus ankle fracture.

During his treatment with osteosynthesis, a proximal avulsion rupture of the flexor digitorum longus (FDL) tendon from the musculotendinous attachment was discovered (figure 2). The flexor hallucis longus (FHL) tendon and posterior tibial neurovascular bundle were intact. The ruptured FDL tendon was interlaced through the FHL tendon and immobilised in a below-knee cast for 6 weeks. He showed a good functional outcome and had returned to work at the 5-month follow-up.



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