Rupture of the tibialis anterior tendon is a rare condition and the diagnosis is frequently delayed, due to subtle changes in foot and ankle function. However, chronic deficits can be visible over time namely progressive gait dysfunction, with a limited dorsiflexion and foot slapping.
The authors describe a case report of an isolated chronic anterior tibial tendon rupture, of a 16-year-old boy, treated with a free flap interposition with gracilis tendon.
The gracilis tendon can safely be used as a free flap interposition in chronic anterior tibial tendon rupture with large tendon defects, with excellent clinical results. Large gaps can be successfully bridged with this technique, with the advantage of sparing the other local tendons and lower donor site morbility.