Behind the Break—A Hidden Tibialis Anterior Tendon Rupture in a Closed Distal Fourth Tibia Shaft Fracture: A Case Report

The patient also displayed foot drop, with an inability to dorsiflex the foot, though distal pulses were intact.Radiographs confirmed a closed displaced distal tibia and fibula fracture, with clinical findings suggestive of associated soft tissue injury (Fig. 4). ManageMent a n d OutcOMeSurgery was performed under spinal anesthesia with sterile aseptic precautions.The patient was positioned supine, and the right lower limb was prepared for the procedure.• The fibula was stabilized using a Titanium Elastic Nail System (TENS).• The tibia was fixed via suprapatellar nailing with proximal and distal screw fixation. clInIcal presentatIOnOn examination, the right leg exhibited swelling and deformity in the distal third, with tenderness, abnormal mobility, and crepitus.