Checkrein deformity: a case report of two patients with hallux deformity and pain following mandibular reconstruction in oral cancer treatment

Sallent, Andrea; Soza, Diego; Duarri, Gemma; Busquets, Rosa

doi:10.1007/s10006-020-00852-9

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Checkrein deformity can occur after trauma because of FHL entrapment within fracture fragments. (12) Checkrein deformity is often found in patients with hallux deformity following a free fibular graft used to fill the mandibular bone defect resulting from oral cancer treatment (13) In extremely rare cases, checkrein deformity can also be caused by EHL hypotrophy (3) due to an increase in intracompartmental pressure caused by subclinical compartment syndrome. The deformity may also be caused by EHL hypotrophy due to an anterior compartment syndrome after tibial fracture, vascular malformation, or by EHL contracture following triplane fracture, (3) progressing into an injury of the musculotendinous junction of the FHL, resulting in mild tendon hypotrophy.…”

Section: Discussionmentioning

confidence: 99%

Release of retromalleolar flexor retinaculum and combined flexor digitorum longus and flexor hallucis longus Z-plasty in checkrein deformity: a case report

Irianto,

Leonarto,

Handoyo

2023

Univ Med

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BackgroundCheckrein deformity is a rare abnormality comprising flexor hallucis longus (FHL) tendon entrapment in the posterior foot due to post-traumatic or ischemic retraction of the FHLtendon following soft tissue trauma. The diagnosis is essentially clinical, but complemented by imaging to rule out unrecognized causes and evaluate the fracture healing process. This case report is the first Indonesian study to describe release of the flexor retinaculum and Z-plasty (lengthening) of flexor digitorum longus (FDL) and FHL tendons through a medial retromalleolar approach to repair the deformity. Case DescriptionWe present the case of a 51-year-old male who complained of clawing of his right first and second toes. The interest of this study lies in the fact that this patient had never experienced ankle or distal tibial fractures, only a trivial injury two years back when the patient kicked a stone at work and had a bruise on his right second toe with no fracture. Exploration of FHL tendons was performed at the level of the midfoot. The patient was planned for surgery with a medial retromalleolar ankle approach, which facilitates the release of the flexor retinaculum, in conjunction with a Z-tenotomy on the FHL and FDL tendons. ConclusionA correction was achieved, and two months post-surgery there were no recurrences of the deformity. However, this surgical procedure requires more cases to support an evaluation of its effectiveness. We suggest that exploration at the ankle and midfoot should be the primary surgical intervention in similar cases of checkrein deformity.

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Section: Discussionmentioning

confidence: 99%

Release of retromalleolar flexor retinaculum and combined flexor digitorum longus and flexor hallucis longus Z-plasty in checkrein deformity: a case report

Irianto,

Leonarto,

Handoyo

2023

Univ Med

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“…Feng et al 12) reported a case of checkrein deformity after fibular osteotomy for autogenous bone grafting for mandible surgery. Sallent et al 13) also reported two cases due to a fibular graft harvesting for the reconstruction of mandibular bone defect secondary to oral cancer treatment. When harvesting the fibular bone, the middle one-third part is typically used, leaving at least 4–6 cm from the fibular head and a minimum of 6 cm from the ankle joint.…”

Section: Etiologymentioning

confidence: 99%

Management of Checkrein Deformity

Kyung,

Cho,

Lee

2024

Clin Orthop Surg

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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. Improvement with conservative treatment is difficult once the deformity has already become entrenched, and surgical management is usually required in severe cases. Various surgical options are available for the correction of checkrein deformities. It includes a simple release of adhesion at the fracture site; lengthening of the flexor hallucis longus by Z-plasty at the fracture site combined with the release of adhesion; lengthening of the flexor hallucis longus by Z-plasty at the midfoot, retromalleolar, or tarsal tunnel area; and flexor hallucis longus tenotomy with interphalangeal arthrodesis for recurrent cases. This review aimed to summarize the overall etiology, relevant anatomy, diagnosis, and treatment of checkrein deformities described in the literature.

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“…9 Many patients complain that their big toe is deformed, causing pain and making it difficult for them to walk. 10 Nowadays, there are no uniform methods of treatment. Some surgeons prefer to find out the reason for adhesion and perform tendolysis when taking out internal fixations, 11,12 while others advocate direct tendolysis surgery.…”

Section: Introductionmentioning

confidence: 99%

“…9 Many patients complain that their big toe is deformed, causing pain and making it difficult for them to walk. 10…”

Section: Introductionmentioning

confidence: 99%

Application of ultrasound in preoperative localization diagnosis of checkrein deformity: A retrospective case series

Yuan

Gao

Jia

2023

J Orthop Surg (Hong Kong)

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Background Checkrein deformity, is a rare claw toe dynamic deformity of the hallux or great toe. This study investigated the use of diagnostic ultrasound in positioning the accurate injury location causing checkrein deformity and its clinical significance for etiological diagnosis and selection of surgical methods. Methods This retrospective study included patients with confirmed checkrein deformities (according to typical symptoms) at the Department of Traumatic Orthopedics of Tianjin Hospital (Tianjin, China) from March 2017 to July 2021. Results A total of 11 patients (8 males and 3 females) with a mean age of 36.7 ± 16.8 (range 19–61) were included in this study. The injuries included six cases of tibia and fibula fracture, one case of single tibia fracture, and one case of single fibula fracture. Four patients were treated with steel plate internal fixation, three patients with intramedullary nailing, and one patient with external fixation. Three patients reported no history of any high-energy trauma or surgery. The ultrasound results showed that seven patients suffered from flexor hallucis longus (FHL) lesions, two patients suffered from flexor digitorum longus (FDL) lesions, and two patients suffered from FHL and FDL lesions. The patients underwent different surgeries tailored to their specific lesions. Toe flexion deformity was completely corrected after operation in all patients. The function of the toes was recovered to varying extent. Conclusion The results of this study demonstrates that the checkrein deformities can be confirmed by ultrasound. It could be used to determine the adhesions before the operation, acting as guidance while establishing the surgical planning.

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Checkrein deformity: a case report of two patients with hallux deformity and pain following mandibular reconstruction in oral cancer treatment

Cited by 4 publications

References 23 publications

Release of retromalleolar flexor retinaculum and combined flexor digitorum longus and flexor hallucis longus Z-plasty in checkrein deformity: a case report

Release of retromalleolar flexor retinaculum and combined flexor digitorum longus and flexor hallucis longus Z-plasty in checkrein deformity: a case report

Management of Checkrein Deformity

Application of ultrasound in preoperative localization diagnosis of checkrein deformity: A retrospective case series

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