Evidence map›Paper›PMID 37698673›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Tibialis posterior tendon entrapment in posterior malleolar and pilon injuries of the ankle: a retrospective analysis.

Junaid Aamir, Anxhela Syziu, Loukas Andritsos, Robyn Caldwell, Lyndon Mason

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Junaid AamirLiverpool Orthopaedic Trauma Service, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK.
Anxhela SyziuSchool and Medicine, University of Liverpool, Liverpool, UK.
Loukas AndritsosLiverpool Orthopaedic Trauma Service, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK.
Robyn CaldwellLiverpool Orthopaedic Trauma Service, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK.
Lyndon MasonLiverpool Orthopaedic Trauma Service, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK. lwmason@liverpool.ac.uk.ORCID http://orcid.org/0000-0002-0371-3183

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Tibialis Posterior tendon (TPT) is the only tendon to encounter the distal tibia and is therefore at greatest risk of injury in fractures of the distal tibia. Although TPT injury has been reported rarely with injuries around the ankle, they often have been missed and present late.

aimOur aim was to analyse the rate to TPT entrapment in fractures involving the posterior tibia, i.e. Pilon (PLM) and posterior malleolar fractures (PMF).

methodsA retrospective analysis of PMF and Pilon fractures over an 8-year period was undertaken. Patients who had undergone surgical fixation of their PMF or PLM were identified from 2014 to 2022, using our prospectively collected database. Any fracture which had undergone a preoperative CT was included. Analysis of their pre-operative CT imaging was utilised to identify TPT entrapment, where if < 50% of the tendon cross section was present in the fracture site, this was denoted as a minor entrapment and if ≥ 50% of the tendon was present in the fracture site was denoted as major.

resultsA total of 363 patients were identified for further analysis, 220 who had a PMF and 143 with PLM injury. The incidence of TPT entrapment was 22% (n = 79) with 64 minor and 15 major entrapments. If the fracture line entered the TPT sheath, there was a 45% rate (72/172) of entrapment as compared to 3.7% (7/190) in fractures not entering the sheath (p < .001). There was no significant difference in TPT entrapment in PMF as compared to PML (p = 0.353).

conclusionIn our assessment, we found significant prevalence of 22% of TPT entrapment in fractures involving the posterior tibia. PMF and PLF had no statistically significant difference in the rate of TPT entrapment. Additionally, we found that there was a significant risk of TPT entrapment when the CT images display the fracture line entering the tendon sheath. We recommend that surgeons consider taking care assessing pre-operative imaging to seek to identify the TPT and to assess intraoperatively where entrapment does occur.

Indexed as

Ankle FracturesTendon EntrapmentTibial FracturesAnkleFracture Fixation, InternalHumansRetrospective StudiesTendonsTibiaPilon fractureTendon entrapmentTibialis posterior

Identifiers

PMID37698673
PMCPMC10858079

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.