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Isolated medial malleolus fractures comprise two-thirds of all ankle fractures and are rarely accompanied by a posterior tibial tendon rupture and dislocation. However, a medial malleolus fracture accompanied by an anterior tibial tendon rupture is unusual, and has not yet been reported. In this paper, a case of medial malleolus fracture accompanied by a tibialis anterior tendon rupture is presented and discussed.