J Korean Foot Ankle Soc.  2022 Dec;26(4):192-195. 10.14193/jkfas.2022.26.4.192.

Spontaneous Degenerative Rupture of Extensor Hallucis Longus Treated with a Split Tibialis Anterior Tendon Autograft: A Case Report

• Kim J
• Kim GLK
• Kim T

• KMID: 2536716
• DOI: http://doi.org/10.14193/jkfas.2022.26.4.192

Abstract

Chronic extensor hallucis longus (EHL) tendon rupture is relatively rare, but in such cases, surgical repair is necessary to prevent hallux dysfunction. To the best of our knowledge, reconstruction of chronic EHL rupture using a split tibialis anterior tendon autograft has not been previously reported. Here we present a case of spontaneous EHL tendon rupture with a 5 cm gap in a healthy 57-year-old woman. At the 1-year follow-up evaluation, hallux function was restored, and the patient was well satisfied with results.

Keyword

Extensor hallucis longus; Tibialis anterior tendon; Tendon autograft

Figure

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  Figure 1 Preoperative macroscopic findings: (A) distal and proximal extensor hallucis longus stumps and (B) insufficient extension of metatarsophalangeal and interphalangeal joints of the hallux.

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  Figure 2 Preoperative magnetic resonance imaging (MRI) findings. Sagittal T2-weighted MRI revealed the rupture of the extensor hallucis longus tendon (arrow).

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  Figure 3 Intraoperative findings: (A) the proximal and distal extensor hallucis longus (EHL) stumps (arrows) following the incision of the tendon sheath and the distal part of the inferior extensor retinaculum. (B) Tibialis anterior (TA) tendon (dotted line) was found medial to the EHL (arrows). (C) TA autograft was sutured to the proximal EHL stump in a Fish-mouth technique. (D) TA autograft was sutured to the distal EHL stump in a Fish-mouth technique. Ankle joint remained at 10 degrees of dorsiflexion, the first metatarsophalangeal joint remained at 10 degrees of extension.

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  Figure 4 Clinical photograph shows extension of the active range of dorsiflexion of the hallux 1 year after reconstruction.

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