How to Treat a Traumatic Anterior Tibial Tendon Rupture

A 37-year-old woman sustained a traumatic laceration to the anterior aspect of the ankle. The wound was closed in the emergency department. On examination, she has a foot drop and ambulates with a stepage gait. MRI shows an anterior tendon disruption. For acute traumatic anterior tibial tendon injuries, surgical repair is recommended. This can be done via direct repair or with soft tissue augmentation. Surgical repair results in improved patient satisfaction. However, isokinetic testing has shown decreased dorsiflexion and inversion strength compared with the uninvolved side. In a very low-demand patient, these injuries can be treated conservatively with an ankle foot orthosis or