The Importance of Surgery in Chronic Muscle Injury

A 45-year-old male presents with complaints that his left foot slaps on the floor when he tries to ambulate. He reports a remote history of playing rugby seven months ago when an opposing player fell on his plantar flex left ankle. On physical examination, he has weak dorsiflexion and increased fatigue with walking. A sagittal T2 MRI and axial MRI is consistent with a chronic anterior tibialis rupture. The choices are one, surgical reconstruction with posterior tibial tendon transfer and gastrocnemius recession. Or five surgical reconstruction with plantaris tendon interposition augmentation. And referral to an orthopedic oncologist for biopsy of the