How to Treat an Acute Tibialis Tendon Rupture

Treatment involves primary tendon repair with possible graft augmentation. Atramatic tibialis anterior ruptures occur in older men greater than 45 years old following eccentric loading against a plantar flexed ankle such as with a misstep. When performing an end-to-end direct tendon repair prior to tensioning the repair, ankle dorsiflexion should be assessed with a knee-infol extension. If the patient is unable to achieve at least 5 degrees of passive dorsiflexion, it is recommended that a gastrocnemius recession be performed.