Case report
Traumatic dislocation of posterior tibial tendon by avulsion of flexor retinacular release. Reconstruction with suture anchors
Luxación traumática del tendón tibial posterior por avulsión del retináculo flexor. Reconstrucción con suturas con anclajes
M. Godino
, M. Vides, E. Guerado
Corresponding author
Departamento de Cirugía Ortopédica y Traumatología, Hospital Costa del Sol, Universidad de Málaga, Marbella, Málaga, Spain
Read
2503
Timeswas read the article
356
Total PDF
2147
Total HTML
Share statistics
array:23 [ "pii" => "S1988885615000206" "issn" => "19888856" "doi" => "10.1016/j.recote.2015.03.002" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "494" "copyright" => "SECOT" "copyrightAnyo" => "2014" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:211-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 123 "formatos" => array:2 [ "HTML" => 88 "PDF" => 35 ] ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S1888441514000812" "issn" => "18884415" "doi" => "10.1016/j.recot.2014.04.004" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "494" "copyright" => "SECOT" "documento" => "simple-article" "subdocumento" => "crp" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:211-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 320 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 238 "PDF" => 73 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nota clínica</span>" "titulo" => "Luxación traumática del tendón tibial posterior por avulsión del retináculo flexor. Reconstrucción con suturas con anclajes" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211" "paginaFinal" => "214" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Traumatic dislocation of posterior tibial tendon by avulsion of flexor retinacular release. Reconstruction with suture anchors" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 621 "Ancho" => 1000 "Tamanyo" => 110237 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se reinserta retináculo con sutura no reabsorbible apoyada en anclajes de 3<span class="elsevierStyleHsp" style=""></span>mm de titanio.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Godino, M. Vides, E. Guerado" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Godino" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Vides" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Guerado" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1988885615000206" "doi" => "10.1016/j.recote.2015.03.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000206?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441514000812?idApp=UINPBA00004N" "url" => "/18884415/0000005900000003/v2_201504151346/S1888441514000812/v2_201504151346/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S1988885615000218" "issn" => "19888856" "doi" => "10.1016/j.recote.2015.03.003" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "528" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:200-10" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 157 "formatos" => array:2 [ "HTML" => 112 "PDF" => 45 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research</span>" "titulo" => "Bone regeneration in experimental animals using calcium phosphate cement combined with platelet growth factors and human growth hormone" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "200" "paginaFinal" => "210" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Regeneración ósea en animales de experimentación, mediante cemento de fosfato cálcico en combinación con factores de crecimiento plaquetarios y hormona de crecimiento humana" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1586 "Ancho" => 2236 "Tamanyo" => 199444 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Statistical results of the morphometric study. (a) ANOVA of the density of the total new bone formation area. (b) ANOVA of the density of the new bone formation area in the medullary cavity. (c) ANOVA of the density of the new bone formation area outside the medullary channel. (d) ANOVA of the density of the area of the remaining biomaterial.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "K. Emilov-Velev, C. Clemente-de-Arriba, M.Á. Alobera-García, E.M. Moreno-Sansalvador, J. Campo-Loarte" "autores" => array:5 [ 0 => array:2 [ "nombre" => "K." "apellidos" => "Emilov-Velev" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Clemente-de-Arriba" ] 2 => array:2 [ "nombre" => "M.Á." "apellidos" => "Alobera-García" ] 3 => array:2 [ "nombre" => "E.M." "apellidos" => "Moreno-Sansalvador" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Campo-Loarte" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441514001714" "doi" => "10.1016/j.recot.2014.07.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441514001714?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000218?idApp=UINPBA00004N" "url" => "/19888856/0000005900000003/v2_201504040248/S1988885615000218/v2_201504040248/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Traumatic dislocation of posterior tibial tendon by avulsion of flexor retinacular release. Reconstruction with suture anchors" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211" "paginaFinal" => "214" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Godino, M. Vides, E. Guerado" "autores" => array:3 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Godino" "email" => array:1 [ 0 => "manugodino@telefonica.net" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Vides" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Guerado" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Cirugía Ortopédica y Traumatología, Hospital Costa del Sol, Universidad de Málaga, Marbella, Málaga, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Luxación traumática del tendón tibial posterior por avulsión del retináculo flexor. Reconstrucción con suturas con anclajes" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 621 "Ancho" => 1000 "Tamanyo" => 106497 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Reinsertion of the retinaculum with non-absorbable suture supported by 3<span class="elsevierStyleHsp" style=""></span>mm titanium anchors.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Traumatic dislocation of the posterior tibial tendon (PTT) is a very rare entity. Very few cases have been described in the literature, starting with the first case reported by Martins in 1874.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> Its onset presents pain and snapping sensation following trauma with ankle inversion, usually during sports practice.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2,3</span></a> The diagnosis is based on a clinical exploration with pain, swelling and ecchymosis in the ankle, and is completed by simple radiographs and magnetic resonance imaging (MRI) scans of the ankle.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> This lesion can sometimes go unnoticed and its treatment should be surgical.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">This work presents a case of acute and traumatic ankle instability due to a dislocation of the PTT whilst running.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was a 28-year-old male with no relevant history who, during the course of an athletics race, suffered a trauma with forced inversion of the right ankle. The clinical exploration found ecchymosis and swelling, with pain upon mobilization of the ankle. We obtained simple anteroposterior and lateral radiographs of the right ankle and treated the lesion by immobilization through a functional bandage and progressive load during 3 weeks. Upon restarting sports practice, the patient reported pain and a snapping sensation in the ankle. Exploration observed the snapping upon forced inversion and dorsiflexion maneuvers. An ultrasound study showed dislocation of the PTT in dorsiflexion and its reduction in plantar flexion. The MRI study revealed bone avulsion of the flexor retinaculum, with no damage to the PTT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The patient underwent surgery 4 months after the lesion, as it had gone unnoticed at the emergency service. The small bone fragment was resected and the retinaculum was reinserted by means of 2 Stryker<span class="elsevierStyleSup">®</span> titanium wedge anchors of 3<span class="elsevierStyleHsp" style=""></span>mm (Kalamazoo, Michigan, USA), as well as reinforcement with non-absorbable suture. The ankle was immobilized for 4 weeks with a plaster cast. After its removal, physiotherapy was started for a period of 2 months (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Full ankle function had been regained 3 months after discharge, with full and asymptomatic plantar flexion, dorsal flexion, inversion and eversion. The ankle presented normal strength. Two years after the lesion, the patient has not suffered a new dislocation, is currently asymptomatic and continues to practice sports with normality (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Dislocation of the PTT is a highly unusual lesion. In 2010, Lohrer and Nauck<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> published a literature review about this entity including 61 cases obtained from the literature until that moment. Only 14% of the patients (8 cases) presented an avulsion fracture, as in the present case. The largest series, with seven cases, was published in 1992 by Ouzounian and Myerson.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The PTT is essential as a dynamic stabilizer of the foot, so loss of its function causes a flat-footed deformity. The mechanism of the lesion has not been fully defined but in most cases it has been associated to forced dorsiflexion and internal tibial rotation of the ankle.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In anatomopathological terms, there have been three types of lesions described:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0045" class="elsevierStylePara elsevierViewall">Type 1: subcutaneous dislocation due to tear of the anterior flexor retinaculum.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0050" class="elsevierStylePara elsevierViewall">Type 2: subperiosteal dislocation due to disinsertion of the anterior retinaculum, with a periosteal flap remaining where the PTT is displaced.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">9,10</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0055" class="elsevierStylePara elsevierViewall">Type 3: avulsion fracture of the flexor retinaculum, as in the present case.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a></p></li></ul></p><p id="par0060" class="elsevierStylePara elsevierViewall">The diagnosis is mainly clinical. Following an ankle inversion trauma, a considerable swelling appears in the area of the medial malleolus, hindering an acute diagnosis. Once the swelling in the tibial perimalleolar region is resolved, the patient has to be reexamined. Occasionally, due to the rarity of the case, patients are not diagnosed and a chronic instability of the PTT remains.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Simple radiographs do not usually provide information except when there is an associated fracture, whereas ultrasound can show tendon dislocation when performing ankle flexion–extension with a slight foot inversion. The MRI scan identifies associated lesions, such as collection of peritendinous fluid, avulsion fracture and lesions of the retinaculum.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Once the diagnosis has been obtained, the indication is surgical treatment<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5,6,9,11</span></a> with reconstruction of the retinaculum through an Achilles tendon flap or else reinsertion and periosteal flap, among other techniques.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> In the present case, we decided to excise the bone fragment as it was too small for an osteosynthesis with a screw and reinsertion of the retinaculum. Once the PTT was reduced we used non-absorbable sutures supported by two titanium anchors of 3<span class="elsevierStyleHsp" style=""></span>mm in the tibial malleolus, as this is a simple technique which provides a solid support.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Level of evidence</span><p id="par0075" class="elsevierStylePara elsevierViewall">Level of evidence V.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Ethical responsibilities</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Protection of people and animals</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declare that this investigation did not require experiments on humans or animals.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Confidentiality of data</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their workplace on the publication of patient data.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Right to privacy and informed consent</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors declare having obtained written informed consent from patients and/or subjects referred to in the work. This document is held by the corresponding author.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres471350" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Case report" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec493835" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres471349" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec493836" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Level of evidence" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-01-26" "fechaAceptado" => "2014-04-01" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec493835" "palabras" => array:6 [ 0 => "Tendon" 1 => "Tibial" 2 => "Posterior" 3 => "Dislocation" 4 => "Avulsion" 5 => "Surgical treatment" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec493836" "palabras" => array:6 [ 0 => "Tendón" 1 => "Tibial" 2 => "Posterior" 3 => "Luxación" 4 => "Avulsión" 5 => "Tratamiento quirúrgico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Traumatic dislocation of the posterior tibial tendon (PTT) has a very low prevalence. It presents with pain and recurrent snapping on the posterior side of the medial malleolus after an ankle sprain while practicing sports. The diagnosis is based on clinical examination, supported by imaging techniques. The treatment must be always surgical.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A 28-year-old man sprained his ankle while jogging. He was treated in an emergency department with an elastic bandage. Once he recovered, he went back to running, noticing a projection with ankle pain. In the physical examination the PTT was reproduced with inversion maneuvers and forced dorsiflexion. Ultrasound and MRI were performed on the ankle. The patient was operated on, leaving a stable ankle with no projection. Three months later he had no pain and restarted his physical activities.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Surgical treatment of PTT dislocation by re-anchoring the flexor retinacula provides an excellent functional outcome.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Case report" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introducción</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La luxación traumática del tendón tibial posterior (TTP) es una entidad con muy baja prevalencia. Debuta con dolor y resalte retromaleolar medial tras un traumatismo en inversión del tobillo con la práctica deportiva. El diagnóstico se basa en la exploración clínica, apoyado en pruebas de imagen. El tratamiento debe ser quirúrgico.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Caso clínico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Varón de 28 años que presenta giro forzado del tobillo en inversión del pie y dorsiflexión del tobillo, mientras realizaba una carrera. Es atendido en urgencias donde se trata como esguince de tobillo con vendaje elástico. Una vez recuperado comienza la práctica deportiva notando un resalte con dolor en el tobillo. En la exploración física se reproduce el resalte del TTP con maniobras de inversión y dorsiflexión forzada. Se completa el estudio con ecografía y RMN. El paciente se interviene quirúrgicamente mediante reinserción del retináculo flexor, quedando un tobillo estable y sin resalte. A los 3 meses postoperatorios el paciente reinicia su práctica deportiva.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusión</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Tras el diagnóstico clínico de luxación del TTP, el tratamiento quirúrgico mediante reinserción del retináculo flexor consiguió un excelente resultado funcional.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Godino M, Vides M, Guerado E. Luxación traumática del tendón tibial posterior por avulsión del retináculo flexor. Reconstrucción con suturas con anclajes. Rev Esp Cir Ortop Traumatol. 2015;59:211–214.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 662 "Ancho" => 500 "Tamanyo" => 37092 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Axial T2 MRI image showing bone avulsion in the tibial malleolus.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 658 "Ancho" => 1000 "Tamanyo" => 133363 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Avulsion fracture of the retinaculum, with release of the bone fragment in the flexor retinaculum.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 621 "Ancho" => 1000 "Tamanyo" => 106497 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Reinsertion of the retinaculum with non-absorbable suture supported by 3<span class="elsevierStyleHsp" style=""></span>mm titanium anchors.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 749 "Ancho" => 1000 "Tamanyo" => 110048 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Image of the ankle in dorsal and inversion 2 years after the operation. The image shows the integrity of the flexor retinaculum.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Notes sur un cas de luxation du muscle tibial potérieur" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.H. Martins" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Acad Chir" "fecha" => "1874" "volumen" => "23" "paginaInicial" => "14" "paginaFinal" => "15" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0065" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento quirúrgico de la inestabilidad lateral crónica de tobillo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.J. Pérez-Caballer" 1 => "J. Sanz-Hospital" 2 => "P. Delgado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Ortp Traumatol" "fecha" => "2004" "volumen" => "48" "numero" => "Suppl. 3" "paginaInicial" => "S53" "paginaFinal" => "S59" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0070" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Traumatic dislocation of tibialis posterior tendon: a case report in a Tae-Kwon-do athlete" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Olivé" 1 => "N. Redón" 2 => "S. Pino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/JSM.0b013e31818f1570" "Revista" => array:6 [ "tituloSerie" => "Clin J Sport Med" "fecha" => "2009" "volumen" => "19" "paginaInicial" => "68" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19124987" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0075" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR Imaging of dislocation of posterior tibial tendon" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Bencardino" 1 => "Z.S. Rosenberg" 2 => "J. Beltran" 3 => "M.R. Broke" 4 => "Y. Cheung" 5 => "L.A. Rosemberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/ajr.169.4.9308473" "Revista" => array:6 [ "tituloSerie" => "AJR" "fecha" => "1997" "volumen" => "169" "paginaInicial" => "1109" "paginaFinal" => "1112" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9308473" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0080" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dislocation of the tibialis posterior tendon: diagnosis and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Rolf" 1 => "I. Gutne" 2 => "T. Ekenman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Foot Ankle Surg" "fecha" => "1997" "volumen" => "36" "paginaInicial" => "63" "paginaFinal" => "65" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9031030" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0085" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posterior tibial tendon dislocation. A systematic review of the literature and presentation of a case" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Lohrer" 1 => "T. Nauck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bjsm.2007.040204" "Revista" => array:6 [ "tituloSerie" => "Br J Sports Med" "fecha" => "2010" "volumen" => "44" "paginaInicial" => "398" "paginaFinal" => "406" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18199628" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0090" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dislocation posterior tibial tendon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.J. Ouzounian" 1 => "M.S. Myerson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Foot Ankle" "fecha" => "1992" "volumen" => "13" "paginaInicial" => "215" "paginaFinal" => "219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1634155" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0095" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Traumatic dislocations of the tibialis posterior tendon at the ankle. Report of a case" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B.E. Nava" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg Br" "fecha" => "1968" "volumen" => "50" "paginaInicial" => "150" "paginaFinal" => "151" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5641586" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0100" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dislocation of the posterior tibial tendon without disruption of the flexor retinaculum. A case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.L. Nucción" 1 => "D.M. Hunter" 2 => "J. Difiori" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Sports Med" "fecha" => "2001" "volumen" => "29" "paginaInicial" => "656" "paginaFinal" => "659" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11573927" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0105" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recurrent dislocation of the posterior tibial tendon secondary to detachment of a retinacular-periosteal sleeve: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Y.S. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Foot Ankle Int" "fecha" => "2004" "volumen" => "25" "paginaInicial" => "602" "paginaFinal" => "604" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15363384" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0110" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Traumatic dislocation of the tibialis posterior tendon: a new surgical procedure to obtain a strong reconstruction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Ballesteros" 1 => "M. Chacón" 2 => "A. Cimarra" 3 => "L. Ramos" 4 => "E. Gómez-Barrena" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Trauma" "fecha" => "1995" "volumen" => "39" "paginaInicial" => "1198" "paginaFinal" => "1200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7500423" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000005900000003/v2_201504040248/S1988885615000206/v2_201504040248/en/main.assets" "Apartado" => array:4 [ "identificador" => "7599" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case report" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000005900000003/v2_201504040248/S1988885615000206/v2_201504040248/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000206?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 0 | 1 |
| 2024 October | 49 | 3 | 52 |
| 2024 September | 28 | 1 | 29 |
| 2024 August | 36 | 5 | 41 |
| 2024 July | 27 | 2 | 29 |
| 2024 June | 52 | 3 | 55 |
| 2024 May | 18 | 3 | 21 |
| 2024 April | 26 | 7 | 33 |
| 2024 March | 37 | 3 | 40 |
| 2024 February | 66 | 8 | 74 |
| 2024 January | 47 | 10 | 57 |
| 2023 December | 61 | 13 | 74 |
| 2023 November | 67 | 4 | 71 |
| 2023 October | 87 | 3 | 90 |
| 2023 September | 58 | 9 | 67 |
| 2023 August | 36 | 9 | 45 |
| 2023 July | 42 | 3 | 45 |
| 2023 June | 55 | 1 | 56 |
| 2023 May | 84 | 4 | 88 |
| 2023 April | 72 | 4 | 76 |
| 2023 March | 68 | 4 | 72 |
| 2023 February | 56 | 1 | 57 |
| 2023 January | 56 | 10 | 66 |
| 2022 December | 45 | 6 | 51 |
| 2022 November | 34 | 3 | 37 |
| 2022 October | 34 | 6 | 40 |
| 2022 September | 36 | 18 | 54 |
| 2022 August | 38 | 5 | 43 |
| 2022 July | 27 | 11 | 38 |
| 2022 June | 28 | 7 | 35 |
| 2022 May | 29 | 6 | 35 |
| 2022 April | 37 | 10 | 47 |
| 2022 March | 40 | 8 | 48 |
| 2022 February | 34 | 5 | 39 |
| 2022 January | 59 | 4 | 63 |
| 2021 December | 33 | 9 | 42 |
| 2021 November | 34 | 8 | 42 |
| 2021 October | 40 | 9 | 49 |
| 2021 September | 54 | 8 | 62 |
| 2021 August | 46 | 5 | 51 |
| 2021 July | 111 | 9 | 120 |
| 2021 June | 33 | 9 | 42 |
| 2021 May | 31 | 6 | 37 |
| 2021 April | 32 | 20 | 52 |
| 2021 March | 32 | 19 | 51 |
| 2021 February | 31 | 9 | 40 |
| 2021 January | 12 | 11 | 23 |
| 2018 February | 9 | 0 | 9 |
| 2018 January | 8 | 0 | 8 |
| 2017 December | 12 | 0 | 12 |
| 2017 November | 11 | 0 | 11 |
| 2017 October | 12 | 0 | 12 |
| 2017 September | 12 | 8 | 20 |
| 2017 August | 6 | 1 | 7 |
| 2017 July | 3 | 1 | 4 |
| 2017 June | 13 | 6 | 19 |
| 2017 May | 1 | 4 | 5 |
| 2016 December | 0 | 1 | 1 |
| 2016 November | 0 | 2 | 2 |
| 2016 August | 0 | 1 | 1 |
| 2016 July | 0 | 1 | 1 |
| 2016 May | 0 | 1 | 1 |
| 2016 April | 0 | 1 | 1 |
| 2016 March | 0 | 1 | 1 |
| 2016 February | 0 | 1 | 1 |
| 2016 January | 0 | 1 | 1 |
| 2015 November | 0 | 1 | 1 |
| 2015 October | 1 | 0 | 1 |
| 2015 September | 0 | 1 | 1 |
| 2015 July | 0 | 1 | 1 |
| 2015 June | 0 | 1 | 1 |
| 2015 April | 0 | 1 | 1 |
Show all
