Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 2, Issue 3 | Case Report | Open Access
Khaled Kamoun*
Pediatric Orthopedic department, Kassab orthopedic Institute, Faculty of Medicine, Tunis El Manar University
*Correspondence to: Khaled Kamoun
Fulltext PDFIntroduction: Flat foot (FF) is a complex deformity that affects often children. Although the cause of pediatric FF is not entirely clear, it is believed to be a multifactorial condition that may involve genetic, environmental, and biomechanical factors. This deformity can occurs when tibialis posterior tendon (TPT) is week in adult but also following a traumatic rupture of this tendon in childhood.
Case Presentation:We report a case of 15-year-old female patient presenting progressive unilateral foot deformity, with a history of neglected foot injury. Physical exam reveals a medial retro-malleolar scar and irreducible hindfoot valgus with medial arch collapse on podoscopic view. Ultrasound and MRI confirmed TPT rupture with retraction of the tendon stump. This deformity impacts on patient’s sport activities. Surgical TPT reconstruction was performed using the flexor hallucis longus (FHL) tendon fixed on navicular through a tunnel bone. Surgery was followed by physiotherapy at cast release. At last follow up correction foot is maintained with restoration of medial arch and children didn’t need a further surgery.
Discussion and Conclusion: Tibialis posterior tendon is important in medial arch foot stability. In children, traumatic rupture of TPT can leads to significant FF deformity. Direct tendon repair is possible when done in emergency but impossible when there is retraction tendon stump. Reconstruction could be a therapeutic alternative procedure using FHL. Our case shows the effectiveness of this procedure leading to foot correction and avoiding more aggressive surgery. However, TPT rupture should be early diagnosis to prevent such deformity.
Flat-foot; Child; Tendon transfer; Tendon injuries; Posterior tibial tendon dysfunction
Khaled Kamoun, Montassar Ayachi, Malek Ben Chaalia, Wajdi Arfa, Hassene Affes, Mourad Jenzri. Acquired Flat-Foot in Children Secondary to Neglected Tibialis Posterior Tendon Rupture a Case Report. Ann Case Rep Clin Stud. 2023;2(3):1-5.