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Torn Flexor Digitorum Longus Tendon and Lacerated Posterior Tibial Artery Associated with an Open Hawkins Type-III Talar Neck FractureA Case Report
Alexander A. Theologis, MD1; Matthew Kwan, MD2; Saam Morshed, MD1
1 Department of Orthopaedic Surgery, University of California-San Francisco (UCSF), UCSF/San Francisco General Hospital Orthopaedic Trauma Institute, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110. E-mail address for S. Morshed: MorshedS@orthosurg.ucsf.edu
2 Department of Plastic Surgery, University of California-San Francisco, 505 Parnassus Avenue, Moffitt M593, San Francisco, CA 94143
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Investigation performed at the Department of Orthopaedic Surgery, University of California-San Francisco (UCSF), UCSF/San Francisco General Hospital Orthopaedic Trauma Institute, San Francisco, California



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Dec 12;2(4):e76 1-5. doi: 10.2106/JBJS.CC.L.00153
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Extract

Talar neck fractures were described as the “aviator astragalus” by Anderson in 1919 because the predominant mechanism of injury was thought to be forced dorsiflexion1. Rotational forces likely account for posteromedial subluxation or dislocation of the talar body, which causes stretching of the dorsal soft tissues2-4. While symptoms associated with bowstringing of the flexor tendons and neurovascular bundle are common, we are not aware of any reports of a talar neck fracture with dislocation of the talar body associated with a flexor muscle avulsion and laceration of the posterior tibial artery. To the best of our knowledge, we detail the first case of an avulsed flexor digitorum longus (FDL) tendon and laceration of the posterior tibial artery associated with an open Hawkins type-III talar neck fracture-dislocation and its early management. The patient was informed that data concerning her case would be submitted for publication, and she provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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