Rupture of the Flexor Hallucis Longus after Hallux Valgus Surgery: Case Report and Comments on Technique for Adductor Release

Foot & Ankle ◽  
1991 ◽  
Vol 11 (6) ◽  
pp. 407-410 ◽  
Author(s):  
Jefferson C. Brand ◽  
Ronald W. Smith
Keyword(s):  
Case Report ◽  
Hallux Valgus ◽  
Flexor Hallucis Longus

Severe Hallux Valgus With Coalition of the Hallux Sesamoids Treated With Modified Lapidus Procedure: A Case Report

2017 ◽  
Vol 10 (6) ◽  
pp. 567-571
Author(s):  
Toshinori Kurashige ◽  
Seiichi Suzuki
Keyword(s):  
Case Report ◽  
Hallux Valgus ◽  
Rare Condition ◽  
Valgus Deformity ◽  
Delayed Union ◽  
Flexor Hallucis Longus ◽  
Computed Tomography Scan ◽  
Hallux Valgus Deformity ◽  
Severe Hallux Valgus ◽  
Tomography Scan

Coalition of the hallux sesamoids is an extremely rare condition. To our knowledge, only 1 case report has been published. We report a case of severe hallux valgus deformities with coalitions of the hallux sesamoids. The coalitions themselves were asymptomatic; however, this severe hallux valgus deformity needed to be surgically treated. The hallux sesamoids in both feet appeared to be fused and heart shaped on anteroposterior radiographs and dumbbell shaped on axial radiographs. It is known that postoperative incomplete reduction of the medial sesamoids can be a risk factor for the recurrence of hallux valgus. The computed tomography scan demonstrated a groove in the bottom of the center of the heart-shaped sesamoid. The flexor hallucis longus tendon was located in the groove. Therefore, a modified Lapidus procedure was performed considering the medial half of the heart-shaped sesamoid as the medial sesamoid. Although delayed union occurred, successful correction of the deformity was achieved. Levels of Evidence: Level IV

Geometric Data of Hallux Valgus Feet

1996 ◽  
Vol 17 (9) ◽  
pp. 548-554 ◽  
Author(s):  
Kenneth S. Lamur ◽  
Anton Huson ◽  
Chris J. Snijders ◽  
Rob Stoeckart
Keyword(s):  
Hallux Valgus ◽  
Least Squares Method ◽  
Metatarsal Bone ◽  
Flexor Hallucis Longus ◽  
Independent Variables ◽  
First Metatarsal ◽  
Linear Dependency ◽  
Geometric Data ◽  
Longus Muscle ◽  
Stepwise Procedure

The aim of this study is to find basic quantitative geometric data that may contribute to the understanding of the etiology of hallux valgus. Embalmed specimens with existing hallux valgus (N = 39) were dissected; 28 variables were measured with a Vernier caliper gauge and toe goniometer. Correlations between pairs of independent variables were calculated. Linear dependency of the hallux angle, varus angle, and the width of the forefoot on a number of independent variables was analyzed by multiple linear regression. A least squares method and a stepwise procedure were used. The distance from the tendon of the flexor hallucis longus muscle to the head of the first metatarsal bone explains more than other variables the variation in hallux angle and width of the forefoot. A widened forefoot is significantly correlated with both hallux and varus angles. The interrelation of the predictor parameters illustrates the complicated hallux valgus phenomenon.

scholarly journals Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review

2021 ◽  
Vol 15 (3) ◽  
pp. 129-136
Author(s):  
Nesrin Mwafi ◽  
Ali Alasmar ◽  
Monther Al-Momani ◽  
Sattam Alazaydeh ◽  
Omar Alajoulin ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Sudden Onset ◽  
Flexor Hallucis Longus ◽  
History Of ◽  
Complete Disruption ◽  
Collagenous Tissues

Abstract Background Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.

Alternative to the Modified Jones Procedure: Outcomes of the Flexor Hallucis Longus (FHL) Tendon Transfer Procedure for Correction of Clawed Hallux

2005 ◽  
Vol 26 (12) ◽  
pp. 1021-1026 ◽  
Author(s):  
Nancy J. Kadel ◽  
Emily A. Donaldson-Fletcher ◽  
Sigvard T. Hansen ◽  
Bruce J. Sangeorzan
Keyword(s):  
Hallux Valgus ◽  
Repeated Measures ◽  
Tendon Transfer ◽  
Joint Angle ◽  
Operative Procedure ◽  
Proximal Phalanx ◽  
Drill Hole ◽  
Lateral View ◽  
Flexor Hallucis Longus ◽  
Valgus Angle

Background: The modified Jones procedure is the traditional operative procedure for correction of a clawed hallux, although the deformity may be caused by over-pull of one of three different muscles. In this study we present the radiographic and functional outcomes of flexor hallucis longus (FHL) tendon transfer as treatment for clawed hallux. The transfer is performed by drawing two thirds of the FHL tendon up through a drill hole in the proximal phalanx and then suturing it medially back to the remaining third. Methods: We retrospectively identified 19 patients (22 feet) who had FHL tendon transfer for correction of clawed hallux over a period of 5 years. Followup was an average of 51.0 (range 6 to 74; ± 3.8) months after the procedure. Outcome and patient satisfaction were determined using the Long-Form Musculoskeletal Function Assessment (MFA) score. Patients were asked whether they were satisfied, somewhat satisfied, or dissatisfied with the overall outcome and were asked about shoewear limitations. Preoperative and postoperative radiographs were evaluated in 15 patients (17 feet). We measured the hallux valgus and interphalangeal (IP) angles on the anteroposterior (AP) radiographs. On the lateral view we measured the angle of the IP joint, the metatarsophalangeal (MTP) joint, and the talometatarsal angle. Statistical analysis was done using a repeated measures ANOVA ( p < 0.05). Results: On the lateral radiographs, the hallux IP joint angle ( p < 0.0012; n = 15) and hallux MTP joint angle ( p < 0.0265; n = 15) were significantly reduced postoperatively. On AP radiographs, the hallux valgus angle ( p < 0.0334) was significantly reduced; however, the IP angle and the talometatarsal angle were not significantly different after surgery. Patients had an average MFA score of 14.6 (±3.8 standard error, range 1 to 35; n = 19). Thirteen patients were fully satisfied and six were somewhat satisfied with the overall result of the surgery. Four patients thought that their hallux limited the types of shoes they could wear, while 15 did not. Conclusion: It has been shown that clawed hallux can result from excessive motor function in one of three muscles: FHL tendon, peroneus longus (PL), and extensor hallucis longus (EHL). This study suggests that transfer of part of the tendon of the FHL is an effective alternative operative procedure for correction of clawed hallux.

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