PMC6742874_01
(a) Anteromedial incision made along the tibialis anterior (TA), centered over the pseudotumor (circled). (b) Superior extensor retinaculum excised revealing underlying hematoma. (c) Tendon defect gap in neutral. (d) Tendon defect gap in maximum ankle dorsiflexion. (e) Whipstitch of TA allograft onto proximal stump. (f) Use of 7mm bio absorbable screw to anchor allograft into medial cuneiform.
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F1
An anteromedial incision along the TA centered over the pseudotumor (Fig. 1a), extending proximally from the superior extensor retinaculum and distally to the medial cuneiform. Unhealthy tendon was debrided (Fig. 1b). The tendon gap was noted to be 4.3 cm in ankle neutral (Fig. 1c) and 3.5 cm when the ankle was maximally dorsiflexed (Fig. 1d). Troy Circle, Centennial, United States) was whipstitched side to side to the proximal stump with a 1-0 braided non-absorbable suture (ULTRABRAID Suture, Smith & Nephew, York, United Kingdom) (Fig. 1e). The medial cuneiform was identified with the aid of an image intensifier and a 7 mm bone tunnel was created with the aid of a guidewire. The distal end of the allograft was passed into the bony tunnel and tensioned with the ankle in maximum dorsiflexion. Its position was fixed with 7 mm x 23 mm bioabsorbable screw (Tenodesis Screw , Arthrex, Naples, Florida, United States) (Fig. 1f).