Tibialis anterior tendon transfer

Case contributed by Dr Jeremy Jones

Presentation

Previous club foot. Pain around then ankle.

X-ray

There is mild hindfoot valgus bilaterally, but alignment is near-normal. There are lucencies projected over the lateral cuneiforms bilaterally consistent with a previous tibialis anterior tendon transfer for the treatment of club foot.

Annotated image

Annotated images of the right foot with the medial, intermediate and lateral cuneiforms and the insertion point of the tibialis anterior tendon in the lateral cuneiform.

The MRI sequences demonstrate normal tibialis anterior muscles in both anterior compartments. Rather than being inserted into the medial aspect of the medial cuneiform, they deviate laterally at the ankle and are inserted through the lateral cuneiform. Features here are of an anterior tibialis tendon transfer.

There is abnormal high signal in the distal tendon of the left tibialis anterior muscle.

Case Discussion

There are a number of non-operative and operative management plans for patients with CTEV (club foot). One operative management plan includes transfer of the tendon insertion point on tibialis anterior from the medial surface of the medial cuneiform to the lateral cuneiform, resulting in a reduction in the degree of equinus and eversion.

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Case information

rID: 23688
Case created: 2nd Jul 2013
Last edited: 15th Oct 2015
Inclusion in quiz mode: Included

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