Rupturas del Tendón Tibial Anterior

Enfoque Terapéutico

Abstract

lntroduction: Anterior tibial tendon ruptures are infrequent. Only 57 cases have been published in the international literature. The purpose of this study is to present an anatomoclinical view and our experience in the treatment of 12cases of anterior tibial tendon ruptures. Material and method: Between January 1990 and Decem ber 2008 twelve patients were diag nosed and treated for isolated ruptures of the anterior tibial tendon. 8 patients were treated functiona lly (without su rgery) and 4 underwent surgical treatment. Patients were subjectively evaluated to asses the degree of satisfaction and objectively eva luated by mea ns of the Ankle and Rear Foot AOFAS scale. Results: All patients were satisfied with the treatment and functional result obtained. The average punctuation in the AOFAS scale for the 12 patients treated was BB points; 89 points on average for those functionally treated and 85 points for those surgica lly treated. There were no com plications in the patients treated functionally and one patient surgically operated had a bowstring deformity. Conclusion: Generally anterior tibial tendon ruptures are not diagnosed initially. Treatment restores the lost function and prevents long term sequelae. The average punctuation obtained in the AOFAS scale were high meaning that the 2 types of treatment in selected patients lead to good results. We agree with various authors in that the treatment should be individualized and adequate for each patient. ln active patients with high functional demands the treatment of choice is surgical and in sedentary patients with low functional demands it should be functional.