Lower Limb Thrombosis after Tibialis Tendon Tenorrhaphy: Case Report and Literature Review
|Gustavo Constantino de Campos*|
|Instituto Wilson Mello, Research and Study Center Rua José Rocha Bonfim, 214 Campinas, SP, Brazil|
|Corresponding Author :||Gustavo Constantino de Campos
Instituto Wilson Mello
Research and Study Center Rua José Rocha Bonfim
214 Campinas, SP, Brazil
E-mail: [email protected]
|Received October 20, 2014; Accepted November 23, 2014; Published November 25, 2014|
|Citation: Campos GCD (2015) Lower Limb Thrombosis After Tibialis Tendon Tenorrhaphy: Case Report and Literature Review. J Trauma Treat 4:222. doi:10.4172/2167-1222.1000222|
|Copyright: © 2015 Campos GCD. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: Rupture of the tibialis anterior tendon is a rare lesion and only few reports are found in the literature. Another not so rare condition is a thromboembolic event following a lower limb surgical procedure or immobilization period. Although there is general agreement that patients undergoing major hip or knee surgery benefit from prophylactic anti-thrombotic therapy, currently there are no unanimously accepted recommendations for thromboprophylaxis in patients with isolated lower limb injury or surgery.
Purpose: The aim of this study is to provide a case report and a critical review of publications on the matter. Case Report: We herein report a case of a 38-year-old man, otherwise well, who sustained a small open wound anterior to the tibiotarsal joint caused by the tip of a knife. Ultrasound confirmed a complete anterior tibialis tendon rupture. Patient underwent to acute repair and was discharged with an ankle cast, with the guidance of full-time use. There was no recommendation of any type of mechanical or pharmacological thromboprophylaxis. Five days later he presented deep venous thrombosis. Treatment was conducted with enoxaparin (20 mg daily) for 3 months.
Discussion: Rupture of the tibialis anterior tendon is decidedly rare and often neglected. Acute repair may be attempted, since delayed tendon reconstruction has had less favorable functional results. Deep venous thrombosis is a potentially life threatening condition that can occur after lower limb injury or immobilization period. We performed a literature review but we cannot draw definite conclusions, given the paucity of high quality studies. In conclusion, there is a need for further research with deeper assessment of thromboprophylaxis indications and contraindications.