Simultaneous flexion and extension checkrein deformity following tibial and fibular fractures: a rare case treated with concomitant surgical intervention.

Checkrein deformity of the hallux is commonly characterized by rigid flexion of the interphalangeal joint in ankle dorsiflexion but with flexibility in ankle plantarflexion which can be named as flexion checkrein deformity and as rare condition, extension checkrein deformity, characterized by rigid extension of the first metatarsophalangeal joint in ankle plantarflexion and flexibility in ankle dorsiflexion, has been reported. However, there has not reported coexistence of flexion and extension checkrein deformity. The patient, a 27-year-old male, was referred to our department 3 years after tibial and fibular fractures which was treated by open reduction and internal fixation at a previous hospital.

The Role of the Flexor Hallucis Longus in the Treatment of the Painful Hallux Metatarsophalangeal Joint.

Background: Pain in the hallux metatarsophalangeal joint (MTPJ) is very common, yet the underlying etiology remains unknown. Previous clinical research and biomechanical research has implicated stenosing flexor hallucis longus (FHL) tendonitis as a possible cause. The hypothesis of this study was that treatment solely focusing on alleviating restricted FHL excursion would be beneficial in patients with hallux MTPJ pain.

Salvage Reconstruction of a 12-cm Tendon Defect Following Chronic Achilles Rerupture-15-Year Follow-Up: A Case Report.

Case: A 39-year-old man with a chronic Achilles rupture status post (1) failed primary repair and (2) secondary xenograft repair with graft rejection, resulting in a 12-cm Achilles tendon defect, which was reconstructed utilizing an Achilles bone block allograft and flexor hallucis longus (FHL) tendon transfer. At 15-year follow-up, the patient reported good functionality and satisfaction with the repair, with positive patient-reported outcome measures. Physical examination revealed excellent strength and range of motion.

Strength and Functional Outcomes Following Achilles Tendon Reconstruction With Hamstring Tendon Autograft Augmentation.

Background: The proposed advantages of hamstring autograft reconstruction when compared to alternative procedures, such as flexor hallucis longus (FHL) transfer, V-Y lengthening, and allograft reconstruction, are improved healing and reproduction of normal tendon biomechanics and reduced morbidity within the foot and ankle. In this study, we examined the effect of Achilles tendon reconstruction using hamstring autografts on strength and functional outcomes.

Methods: Patients who underwent Achilles repair with a hamstring autograft for insertional or midsubstance tendinopathy, delayed diagnosis of rupture, or infection after primary repair were evaluated for inclusion.

Management of Checkrein Deformity.

Checkrein deformity is characterized by the dynamic status of the hallux, in which flexion deformity is aggravated by ankle dorsiflexion and relieved by ankle plantarflexion. In most cases, a checkrein deformity occurs secondary to trauma or following surgery. It has been suggested that the flexor hallucis longus tendon tethers or entraps scar tissue or fracture sites.

Talar Arthroscopic Reduction and Internal Fixation (TARIF): A Novel All-Inside Soft-Tissue-Preserving Technique.

Background: Talar arthroscopic reduction and internal fixation (TARIF) is an alternative approach for the operative fixation of talar fractures that may be utilized instead of more traditional open approaches such as medial, lateral, or even dual anterolateral. The TARIF approach allows for nearly anatomic fracture reduction and fixation of talar neck, body, and posterior dome fractures while minimizing the soft-tissue stripping and vascular injury associated with the standard anterolateral approach.

Description: Following initial closed fracture reduction and any associated procedures, we recommend obtaining computed tomography scans of the injured ankle in order to evaluate the fracture pattern and allow for preoperative planning.

Long-term outcome of flexor hallucis longus tendon transfer for chronic Achilles tendon rupture with large defect: A retrospective series.

There are multiple surgical options for treatment of chronic Achilles tendon (AT) rupture according to the classifications and length of defect. However, no gold standard method has been confirmed, and there is no clear evidence to support the superiority of 1 procedure over others. This study aimed to evaluate the long-term clinical outcome of flexor hallucis longus tendon (FHL) transfer for chronic AT rupture with large defect.

Flexor hallucis longus tendon morphology in dancers clinically diagnosed with tendinopathy.

Purpose: The unique demands of dance technique make dancers more prone to certain pathologies especially of the foot and ankle. Flexor hallucis longus (FHL) tendinopathy, colloquially known as "dancer's tendinopathy," is common in dancers and not well studied. The purpose of this study was to assess if morphological alterations in tendon structure occur as an adaptive response to dance activity by comparing the FHL tendon in dancers to non-dancers, and if pathology further alters tendon morphology in dancers clinically diagnosed with tendinopathy.

Endoscopically Assisted Percutaneous Harvesting of the Flexor Hallucis Tendon in Zone 2: An Anatomical Study.

Background: Flexor hallucis longus (FHL) transfer is a well-established method for treating chronic Achilles tendon ruptures and tendinopathy. Harvesting of the FHL tendon in zone 2 results in greater length but is also associated with an increased risk of injury to the medial plantar nerve and requires an additional plantar incision. Because of the anatomic proximity of the FHL tendon to the tibial neurovascular bundle in zone 2, the purpose of this study was to investigate the risk of vascular or nerve injury with arthroscopic assisted percutaneous tenotomy in zone 2 of the FHL tendon.

Presurgical Perspectives and Post-treatment Evaluation of Achilles Tendon Injuries.

The Achilles is a commonly injured tendon, prone to degeneration and tear. Achilles tendon treatment ranges from conservative management to injections, tenotomy, open versus percutaneous tendon repair, graft reconstruction, and flexor hallucis longus transfer. Interpreting postoperative imaging of the Achilles tendon is a difficult task for many providers.

Simulation of Lower Limb Muscle Activation Using Running Shoes with Different Heel-to-Toe Drops Using Opensim.

Background: Although numerous studies have been conducted to investigate the acute effects of shoe drops on running kinematics and kinetic variables, their effects on muscle forces remain unknown. Thus, the primary aim of this study was to compare the muscle force, kinematics, and kinetic variables of habitually rearfoot runners with heel-to-toe drops of negative 8 mm shoes (minimalist shoes) and positive 9 mm shoes (normal shoes) during the running stance phase by using musculoskeletal modeling and simulation techniques.

Methods: Experimental data of lower limb kinematics, ground reaction force, and muscle activation from 16 healthy runners with rearfoot strike patterns were collected and analyzed in OpenSim.

Exploration of muscle-tendon biomechanics one year after Achilles tendon rupture and the compensatory role of flexor hallucis longus.

Achilles tendon (AT) rupture leads to long-term structural and functional impairments. Currently, the predictors of good recovery after rupture are poorly known. Thus, we aimed to explore the interconnections between structural, mechanical, and neuromuscular parameters and their associations with factors that could explain good recovery in patients with non-surgically treated AT rupture.

Presentation, Diagnostic Dilemma, and a Novel Approach of Fixing a Cedell's Fracture - A Case Report.

Introduction: Fractures of the posteromedial tubercle of talus are one of the rarer fractures encountered in clinical practice. They mostly present like an ankle sprain which often leads to missed injuries and delayed diagnosis. We present one such case, incorporating the dilemmas associated with its diagnosis, treatment, approach to the treatment and a novel way of fixation and the outcome.

Evaluation of Flexor hallucis tendon transfer in chronic insertional Achilles tendinopathy in over 50-year-old population using validated ankle scores.

Purpose: Chronic insertional Achilles tendinopathy is a common pathology in the over 50 years old population. Patients not relieved with conservative treatment had to undergo surgical intervention for the management. This study evaluates the clinical outcome of FHL transfer in such patients using validated ankle functional scores.

Single-stage Flexor Hallucis Longus transfer and Gracilis free flap cover for failed Achilles tendon repair with soft tissue defect.

Introduction: Reconstruction of failed Achilles tendon repair, with infection and loss of overlying skin, is a surgical challenge. This paper aims to deal with the technical considerations and study the outcome of reconstructing such defects by radical debridement and reconstruction with combined Flexor hallucis longus (FHL) transfer and free Gracilis flap cover.

Materials And Methods: A retrospective study of six patients with failed Achilles tendon repair with overlying skin and soft tissue loss reconstructed by FHL transfer and free Gracilis flap cover performed between January 2017 and August 2020 was conducted.

Dance-Related Foot and Ankle Injuries and Pathologies.

Dancers are highly vulnerable to injuries due to high dynamic overload, extreme positions and motions, and excessive use. Increased load at the forefoot with jumping and high-impact lands can cause sesamoiditis and stress fractures of the metatarsals. Significant plantarflexion can lead to posterior joint impingement and flexor hallucis longus tendonitis, whereas forced dorsiflexion can cause anterior joint impingement.

Chronic Rupture of Achilles Tendon Caused by Haglund's Deformity: A Case Report.

A chronic Achilles tendon rupture is a tendon rupture occurring more than 4-6 weeks after a traumatic injury. Haglund's deformity, caused by bony abnormalities in the ankle (mostly due to osteophyte or bone spur), can cause chronic inflammation and degeneration of the Achilles tendon, eventually leading to rupture. This presents a challenge for clinicians who provide tendon repair procedures.

[Reconstruction of Soft Tissue Defects of the Achilles Tendon Region: a Literature Review].

Background: Soft tissue defects in the achilles tendon region occur after trauma, but also as a complication after open recon- struction of the tendon with subsequent infection.

Objectives: Recommendations for the treatment of soft tissue injuries involving the Achilles tendon are presented.

Materials And Methods: A search of the German, French and English literature on reconstruction of soft tissue defects of the Achilles tendon region was performed, which were differentiated into singular and combined tendocutaneous defects.

Outcomes of Percutaneous Achilles Repair Compared With Endoscopic Flexor Hallucis Longus Tendon Transfer to Treat Achilles Tendon Ruptures.

Background: Both percutaneous and endoscopically assisted methods are reported to produce good results in the surgical management of acute Achilles tendon ruptures. The aim of this retrospective study was to compare between a percutaneous method and a recently described isolated endoscopically assisted flexor hallucis longus (FHL) transfer method as surgical means of management in patients with acute Achilles tendon ruptures.

Methods: One hundred seventeen patients were included in the current study and divided into 2 groups: 59 patients who underwent percutaneous Achilles repair (PAR Group) and 58 patients who underwent isolated endoscopic FHL transfer (FHL Group) were compared.