Closed Complete Rupture of the Flexor Hallucis Longus Tendon at the Groove of the Talus

1997 ◽  
Vol 18 (1) ◽  
pp. 47-49 ◽  
Author(s):  
Suguru Inokuchi ◽  
Norio Usami
Keyword(s):  
Soccer Player ◽  
Metatarsophalangeal Joint ◽  
Tendon Graft ◽  
Soccer Players ◽  
Flexor Hallucis Longus ◽  
Partial Rupture ◽  
Longus Tendon ◽  
Complete Rupture ◽  
Active Flexion ◽  
Classical Ballet

A rare case of closed complete rupture of the flexor hallucis longus tendon at its groove in the posterior process of the talus is reported in a soccer player who developed pseudarthrosis of the posterolateral tubercle of the talus after a Shepherd's fracture. Partial rupture or tenosynovitis of the flexor hallucis longus tendon at this level is well known in classical ballet dancers and soccer players. Three cases of complete rupture of the flexor hallucis longus tendon near the metatarsophalangeal joint and three under the sustentaculum tali have been reported, but there have been no reports at the groove of the talus. Repair was accomplished by tendon graft, and active flexion of the interphalangeal joint is now possible.

Three-dimensional Reconstruction of Magnetic Resonance Images of a Displaced Flexor Hallucis Longus Tendon in Hallux Valgus

2005 ◽  
Vol 95 (4) ◽  
pp. 401-404 ◽  
Author(s):  
Antal P. Sanders ◽  
René E. Weijers ◽  
Christiaan J. Snijders ◽  
Lew C. Schon
Keyword(s):  
Magnetic Resonance ◽  
Hallux Valgus ◽  
Lateral Displacement ◽  
Three Dimensional ◽  
Metatarsophalangeal Joint ◽  
Biomechanical Model ◽  
Magnetic Resonance Images ◽  
Flexor Hallucis Longus ◽  
First Metatarsophalangeal Joint ◽  
Longus Tendon

By using three-dimensional magnetic resonance image reconstruction, lateral displacement of the flexor hallucis longus tendon and sesamoid bones was made clearly visible in a living patient. This finding supports a biomechanical model related to disturbed muscle balance at the first metatarsophalangeal joint, which could play an important role in the pathogenesis of hallux valgus and metatarsus primus varus. (J Am Podiatr Med Assoc 95(4): 401–404, 2005)

scholarly journals Technique

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0019
Author(s):  
Natalie Danna ◽  
James Rizkalla ◽  
James Brodsky
Keyword(s):  
Bone Graft ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Flexor Hallucis Longus ◽  
Dorsal Approach ◽  
First Metatarsophalangeal Joint ◽  
Fusion Construct ◽  
Longus Tendon ◽  
Joint Fusion ◽  
Joint Surfaces

Category: Midfoot/Forefoot Introduction/Purpose: Sesamoidectomy is most often indicated for sesamoid fractures. The procedure may also be a useful option for cases of recalcitrant sesamoiditis, osteochondritis dissecans, and osteoarthritis. In instances of concomitant arthritis of the first metatarsophalangeal joint and the sesamoids, sesamoidectomy may be performed in tandem with first metatarsophalangeal joint fusion. This carries the additional benefit of harvesting bone graft from the excised sesamoid to include in the fusion construct. Though sesamoidectomy is commonly performed through a medial or plantar approach, neither of these approaches are suited to fusion of the first metatarsophalangeal joint. Sesamoidectomy can be performed effectively through a dorsal approach and is the preferred technique when performed in conjunction with first metatarsophalangeal joint fusion. Methods: A dorsal midline incision is made over the first metatarsophalangeal joint. Care is taken to protect the extensor hallucis longus tendon while dissection proceeds to the joint capsule. The capsule is incised and released so that the first metatarsophalangeal joint can be sufficiently mobilized. Next, the opposing joint surfaces are prepared, increasing the mobility of the joint and exposure of surrounding structures. Results: (technique, continued) A sharp retractor is used to elevate the metatarsal head. Hyperflexion of the metatarsophalangeal joint may increase visualization of the sesamoids. A fresh knife is used to tease the sesamoid away from the flexor hallucis longus tendon, beginning at one edge of the sesamoid. The bone is carefully elevated off the tendon while dissection proceeds around the perimeter. Once the sesamoid has been freed and excised, the tendon is examined for injury. The excised sesamoid can then be cleared of soft tissue and cartilage and morselized for bone graft. Conclusion: The dorsal approach is effective for sesamoidectomy and efficient when performed as an adjunct to first metatarsophalangeal joint fusion.

Partial Rupture of the Flexor Hallucis Longus Tendon in a Tennis Player: A Case Report

1995 ◽  
Vol 16 (4) ◽  
pp. 227-231 ◽  
Author(s):  
Elly Trepman ◽  
Mark S. Mizel ◽  
Arthur H. Newberg
Keyword(s):  
Muscle Fibers ◽  
Scar Tissue ◽  
Nonoperative Treatment ◽  
Flexor Hallucis Longus ◽  
Great Toe ◽  
Partial Rupture ◽  
Longus Tendon ◽  
Operative Findings ◽  
The Right ◽  
Flexor Digitorum

A 39-year-old woman sustained a forced dorsiflexion injury to the left great toe while pivoting to the right during tennis activity. Posteromedial ankle pain was reproduced with active plantarflexion and passive dorsiflexion of the great toe and, to a smaller extent, the lesser toes. Symptoms persisted for 9 months despite nonoperative treatment. Magnetic resonance imaging 5 months after injury revealed evidence of fluid surrounding the flexor hallucis longus (FHL) tendon. Operative findings 9 months after injury included scar tissue and tenosynovitis of the FHL and flexor digitorum longus tendon sheaths, with impingement of distal FHL muscle fibers and a longitudinal split tear (partial rupture) of the FHL tendon. Tenolysis, tenosynovectomy, excision of the distal muscle fibers, and repair of the partial tendon rupture were performed, resulting in resolution of symptoms. Partial rupture of the FHL tendon as a single-impact injury, or in activity other than ballet, has not been documented previously.

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