CC BY-NC-ND-license · Joints 2016; 04(03): 183-188
DOI: 10.11138/jts/2016.4.3.183
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review

Alessandro Ortolani
1   I Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna, Italy
,
Roberto Bevoni
2   Ortopedia Bentivoglio, Istituto Ortopedico Rizzoli, Bentivoglio (BO), Italy
,
Alessandro Russo
1   I Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna, Italy
,
Maurilio Marcacci
1   I Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna, Italy
,
Mauro Girolami
2   Ortopedia Bentivoglio, Istituto Ortopedico Rizzoli, Bentivoglio (BO), Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
15 September 2017 (online)

Abstract

Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event.

Irreducibility of an ankle dislocation, which is rarely encountered, can be due to soft tissue interposition. Dislocation of the posterior tibial tendon can be the cause of an irreducible talar dislocation; interposition of this tendon, found to have slid posteriorly to the distal tibia and then passed through the tibioperoneal syndesmosis, is reported in just a few cases of ankle fracture-dislocation.