Closed Medial Malleolar Multifragment Fracture With a Posterior Tibialis Tendon Rupture: A Case Report and Review of the Literature

Ankle fractures represent an excitingfield of traumatology because of the wide variety of clinical pre-sentations, injury mechanisms, and treatment options. Rupture of the posterior tibialis tendon (PTT) withankle fracture can occur during trauma that involves pronation and external rotation of the foot or, lesscommonly, secondary to direct trauma to the ankle. This tendon injury is uncommon and probably mis-diagnosed in many cases, because of the difficult clinical examination secondary to the pain and swelling. Theidentification and early treatment of PTT tears is essential for good functional outcomes to prevent the mainmid- to long-term complication of disabling acquiredflatfoot due to tendon failure. In the present report, weprovide a review of the published data regarding ankle fractures associated with PTT rupture and describe ourexperience with a case of a multifragment medial malleolus fracture and complete rupture of the PTT diag-nosed intraoperatively and surgically treated in a 34-year-old male, with 2.5 years of follow-up.