Closed Tibial Fracture Associated with Laceration of Tibialis Anterior Tendon

Traumatic laceration of the tibialis anterior tendon is a rare finding. To the best of our knowledge, 4 such cases have been reported in the surgical literature, and 3 of these were missed upon initial clinical examination. We present the case of a 26-year-old male motorcyclist who sustained an acute laceration of the tibialis anterior tendon in association with closed fractures of the tibia and fibula. The laceration was initially not included in the diagnosis, because weak ankle dorsiflexion was attributed to antalgic guarding. The primary aim of this report is to emphasize the possibility of tibialis anterior tendon laceration in association with closed fracture of the tibia, and to encourage surgeons to maintain a high index of suspicion for this particular defect. Furthermore, we encourage surgeons to undertake a meticulous physical examination and, if warranted, obtain ancillary diagnostic images, such as magnetic resonance images, in order to accurately diagnose and determine the optimal course of treatment. (C) 2010 by the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.