Table 1: Studies on tendon ruptures after tibial shaft fractures.

Author (year)Number of
of injury
DiagnosisTime of
TreatmentDuration of

Grenier and Guimont [5] (1983)139WeightliftingBilateral quadriceps tendon rupture w/left distal tibia oblique fxPreoperativeBilateral repair of quadriceps tendons with limited ORIF with screws for distal tibia fx5 yearsExcellent with FROM in the knee
Mirza and Korber [3] (1984)119 FMCCDistal tibial oblique shaft fx w/ipsilateral ATT rupture1 year following injuryLLC for distal tibia fx; repair of ATT rupture; delayed direct repair after tenolysis8 months10-degree active dorsiflexion and normal plantar flexion
Korovessis et al. [6] (1991)126 MMidshaft tibia w/ipsilateral PTT and FDL ruptureIntraoperativeORIF tibia and direct repair of PTT and FDL6 months10-degree ankle dorsiflexion deficit
Din and Therkilsden [1] (1999)141 MMCCMidshaft tibia fx w/ipsilateral ATT rupturePostoperativeIMR tibia; repair of ATTNRNR
Givissis et al. [7] (2004)117MCCDistal tibia fx w/ipsilateral ATT rupturePreoperativeORIF distal tibia fx w/plates and screws and direct repair of ATT3 yearsFull active dorsiflexion
Mechrefe et al. [8] (2006)132 MMVCDistal tibia fx with avulsion fx of tibialis anterior tendon insertionIntraoperativeORIF of tibia fx w/plates and screws and repair of ATT avulsion with suture anchors6 monthsExcellent; no bracing needed
Ebrahimi et al. [9] (2010)126 MMCCDistal tibia comminuted fx w/ATT ruptureIntraoperativeORIF distal tibia fx w/plates and screws and direct repair of ATT12 monthsReturn to work and recreational activities
Hill et al. [4] (2011)127 MMCCOpen distal tibia fx w/achilles tendon ruptureIntraoperativeIMR tibia; direct repair of Achilles tendon5 monthsReturn to full activity
Jarvis and Cannada [10] (2012)148 MMCCDistal tibia-fibula fx (OTA type 43A) w/PTT ruptureIntraoperativeBridging Ex-fix followed by ORIF tibia and fibula; PTT direct tenodesis to FDL1 yearAOFAS score 85/100; return to work
Our patient167 MFall with twisting injuryDistal tibia oblique fx w/quadriceps tendon rupture w/IntraoperativeQuadriceps tendon repair and IMR tibia and ORIF posterior malleolus fx6 monthsReturn to work and recreational activities

PTT: posterior tibial tendon; ATT: anterior tibial tendon; ORIF: open reduction internal fixation; MVA: motor vehicle accident; MCC: motor cycle crash: IMR: intramedullary rodding; OTA: orthopaedic trauma association; Fx; fracture; NR: not reported; Ex-Fix: external fixator; FDL: flexor digitorum longus; w/: with; Fx: fracture; FROM: full range-of-motion.