Triggering of the big toe, or hallux saltans, is commonly due to stenosing tenosynovitis of the flexor hallucis longus at the fibro-osseous tunnel below the sustentaculum tali. It is a rare condition described mainly in female ballet dancers. This is hypothesized to be due to the en pointe position used in ballet, which puts enormous supraphysiologic loads on the flexor hallucis longus, predisposing it to injury. Trigger hallux is extremely uncommon in the general population. We are reporting a case of hallux saltans in an unskilled manual laborer, with the site of tendon entrapment just proximal to the medial malleolus in the distal leg, a hitherto unreported location of stenosis.

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http://dx.doi.org/10.1053/j.jfas.2012.02.014DOI Listing

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