Medial ankle sprains have a very low incidence (5% of ankle ligament injuries), and most of the time, the first structure involved is the deltoid ligament complex. However, other structures, such as the spring ligament, posterior tibial tendon, and flexor retinaculum, can also get damaged. A 32-year-old man who had an ankle sprain while performing sports activities showed magnetic resonance imaging findings compatible with a detachment of the flexor retinaculum and medial dislocation of the posterior tibial tendon. Surgical intervention was suggested to this patient; deepening of the medial retromalleolar groove and reattaching of the retinaculum were performed. It is very important to consider this rare injury after a medial ankle sprain and to think out of the box, not always assuming a deltoid ligament lesion. Level of Evidence V; Therapeutic Studies; Expert Opinion.
Hallux saltans is a rare condition characterized by an entrapment of the flexor hallucis longus. Its tendon passes through the retromalleolar groove below the flexor retinaculum, directing the plantar aspect of the foot through a fibro-osseous tunnel below the sustentaculum tali. This study presents a young active patient without any of the conditions or etiological agents previously described in the literature that could explain the cause of this rare condition. After failing conservative treatments, an arthroscopic release of the tendon and the fibrous tunnel was performed, achieving direct visualization and minimal soft tissue injury. At six month follow-up, the patient resumed sports and daily living activities without symptoms. Level of Evidence V; Therapeutic Studies; Expert Opinion.
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