Surgical Correction of Checkrein Deformity after Malunited Distal Tibia Fracture: A Case Report

• Published in: The Journal of foot and ankle surgery Vol. 53; no. 5; pp. 631 - 634
• Main Authors: Holcomb, Timothy M., DPM, AACFAS, Temple, Eric W., DPM, Barp, Eric A., DPM, FACFAS, Smith, Hayden L., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014
• Subjects: ankle fracture; Arthrodesis; Contracture - etiology; Contracture - surgery; flexor hallucis longus adhesions; Foot Deformities, Acquired - diagnostic imaging; Foot Deformities, Acquired - etiology; Foot Deformities, Acquired - surgery; Fractures, Malunited - complications; Hallux; Hammer Toe Syndrome - diagnostic imaging; Hammer Toe Syndrome - etiology; Hammer Toe Syndrome - surgery; hammertoes; Humans; Joint Dislocations - diagnostic imaging; Joint Dislocations - surgery; Male; Orthopedics; Radiography; tendinous adhesions; Tendon Injuries - etiology; Tendon Injuries - surgery; Tenotomy; Tibial Fractures - complications; Toe Joint - diagnostic imaging; Toe Joint - surgery; Young Adult; flexor hallucis longus adhesions; 4; tendinous adhesions; ankle fracture; hammertoes
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2014.04.028

Abstract Checkrein deformities are rare and involve entrapment or tethering of the flexor hallucis longus and, occasionally, flexor digitorum longus tendons. The deformity has typically been secondary to traumatic fractures of the talus, calcaneus, or deep posterior compartment syndrome resulting from fractures of the tibia and fibula and most fractures of the ankle. These result in flexion contractures at the interphalangeal joint of the hallux. Because of the rarity of this deformity, no single surgical technique has been defined as the standard. Previous interventions have included release of adhesions with or without Z-plasty lengthening of the involved tendons. The present study reports a case of checkrein deformity secondary to a malunited distal tibia fracture, with flexion deformities to digits 1 through 3. The patient underwent successful surgical correction with flexor tenotomies to the affected digits with interphalangeal arthrodesis to the hallux.