Downloaded from http://journals.lww.com/jbjscc by BhDMf5ePHKbH4TTImqenVCbF2BRbWAbdBNef+ybEM98c/hIt1LGpXTdCGfcTZWLCpoaxTKN7vys= on 06/23/2020 Tibialis Posterior Tendon Dislocation A Case Report Pedro Teixeira da Mota, MD, Rita Sapage, MD, Carlos Branco, MD, Rita Sousa, MD, Diogo Sousa, MD, and Carlos Pintado, MD Investigation performed at Centro Hospitalar de Tr´ as-os-Montes e Alto Douro, Vila Real, Portugal Abstract Case: A 37-year-old man presented after a sudden snap followed by pain in the medial side of the ankle while playing football. Physical examination showed edema and pain posteriorly to the medial malleolus, and a longitudinal structure was palpable anteriorly. Ultrasound confirmed a dislocated tibialis posterior tendon (TPT). The patient underwent surgery, and the flexor retinaculum was repaired. Six months after the surgery, he was asymptomatic and had resumed his usual physical activity, with an AOFAS score of 100. Conclusion: TPT dislocation is rare and orthopaedic surgeons should be aware of this condition in patients with a sudden traumatic medial ankle pain. T ibialis posterior tendon (TPT) dislocation was first described by Martius in 1874, in a self-reported case report 1 . Multiple mechanisms of traumatic TPT dislo- cation were described in literature, including plantar flexion and inversion, falling while the foot is in varus, repeated forced inversion, forceful dorsiflexion, and eversion or twisting injuries 2 . The diagnosis is frequently delayed because this injury is commonly overlooked. A careful history and physical Fig. 1 Normal anteroposterior and lateral ankle radiographs. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJSCC/B137). 1 COPYRIGHT Ó 2020 BY THE J OURNAL OF BONE AND J OINT SURGERY,I NCORPORATED JBJS Case Connect 2020;10:e19.00590 d http://dx.doi.org/10.2106/JBJS.CC.19.00590