PMC4573416_01
Radigraph showing avulsion fracture from the medial cuneiform and base of first metatarsal.
gr1.jpg
PMC4573416_01_gr1.jpg
fig0005
The X-ray examination of the foot revealed an avulsion fracture of the base of the first metatarsal (Fig. 1).
MRI picture showing avulsion of tibialis anterior.
gr2.jpg
PMC4573416_01_gr2.jpg
fig0010
An MRI scan of the foot was done to delineate the fracture, which showed avulsion of the attachment of tibialis anterior from the base of first metatarsal and medial cuneiform (Fig. 2).
Operative picture showing avulsion of tibialis anterior tendon.
gr3.jpg
PMC4573416_01_gr3.jpg
fig0015
The tibialis tendon was found to be avulsed from the base of first metatarsal and medial cuneiform (Fig. 3).
Picture showing whip stitch being applied to the avulsed tendon end.
gr4.jpg
PMC4573416_01_gr4.jpg
fig0020
The tendon was mobilised and whip stitch applied to the avulsed end with ethibond sutures (Fig. 4).
Picture showing the final repair of the tendon after being attached to the base of first metatarsal.
gr5.jpg
PMC4573416_01_gr5.jpg
fig0025
This was attached to the base of the first metatarsal with suture anchors and augmented with vicryl sutures, with his foot held in dorsiflexion (Fig. 5).
Radigraph at 8 weeks showing the healed avulsion fracture.
gr6.jpg
PMC4573416_01_gr6.jpg
fig0030
An X-ray taken showed that tendon has started to heal (Fig. 6).