Anterior tibialis tendon ruptures: An outcome analysis of operative versusnonoperative treatment

Ruptures of the anterior tibialis tendon are a rare clinical entity. Case r eports in the literature reveal a total of 28 cases. Unfortunately, because of the limited discourse in the orthopaedic literature, there are few guid elines regarding the treatment for these injuries. This study analyzes the treatment of 16 anterior tibialis tendon ruptures. Eight patients in this g roup had operative treatment of their ruptures, and eight patients had nons urgical treatment of their ruptures. The average follow-up for the operativ e and nonoperative patients were 6.68 years and 3.86 years, respectively. T he Foot and Ankle Outcome questionnaire provided by the American Academy of Orthopaedic Surgeons and an outcome-based foot score described by Kitaoka et al. were used as the methods of analysis. Our outcome results show no st atistically significant difference between operative and nonoperative treat ment in anterior tibialis tendon ruptures. The lack of statistical difference between operative and nonoperative group s may be a reflection of the age bimodality present in this study. Elderly row demand patients were treated nonsurgically and young active patients we re treated operatively. Therefore, despite a lack of statistical difference present in the outcome of both groups, we still maintain the need to repai r/reconstruct anterior tibialis tendon ruptures in young active patients wi th high functional demands. The deficits present in the nonoperative group, we believe, would not be well tolerated in a young high functional demand patient. Nonsurgical management is an appropriate alternative in low demand elderly patients.