Checkrein Deformity Associated with Intra-Articular Talar Fracture

Abolfotouh, Sameh M.; Mahmoud, Karim M.; Mekhaimar, Mohamed M.; Said, Nader; Dosari, Mohammed A. Al

doi:10.2106/jbjs.cc.n.00024

Cited by 7 publications

(9 citation statements)

References 10 publications

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“…Checkrein deformity of the great toe secondary to entrapment of the flexor hallucis longus tendon has been described after fractures of the talus and ankle and after fibular graft removal. 30 - 32 Similar to our case, Tucker et al 33 noticed slight plantar flexion of the toes at the metatarsal-phalangeal and interphalangeal joints after a closed, lateral subtalar joint dislocation. However, a checkrein deformity was not diagnosed in this case.…”

Section: Discussionsupporting

confidence: 86%

Closed Pantalar Dislocation With Checkrein Deformity: A Unique Case Report and Literature Review

Speer¹,

Pike²

2021

JAAOS Glob Res Rev

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Closed pantalar dislocations are a rare variant of an uncommon injury. Pantalar dislocations are typically caused by high-energy trauma resulting in an open injury with associated fracture of the articulating bones. Given its obscurity, the literature on closed pantalar dislocations is scarce, and no standard treatment protocol has been accepted. This case report chronicles the treatment and outcome of a 29-year-old man who presented with a checkrein deformity of all digits after a closed pantalar dislocation with 6-month follow-up. A comprehensive literature review found 28 articles representing 39 patients with closed pantalar dislocations without talar neck or body fractures. Roughly equal numbers of closed and open reduction techniques were performed with avascular necrosis occurring in 7 of 36 patients. Although outcome measures and follow-up were variable, what can be considered a suitable outcome was seen in approximately 83% of patients, with only 3 of 35 requiring a secondary operation. Long-term studies with well-defined outcome measures are needed to adequately predict the prognosis of this rare injury and efficacy of treatment protocols.

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Section: Discussionsupporting

confidence: 86%

Closed Pantalar Dislocation With Checkrein Deformity: A Unique Case Report and Literature Review

Speer¹,

Pike²

2021

JAAOS Glob Res Rev

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“…The FHL tendon distinctively functions to flex the great toe, and tethering of the tendon can lead to flexion contracture of the interphalangeal joint of the big toe, a finding known as the checkrein deformity 5,6 . Abolfotouh et al reported 3 cases of FHL entrapment with subsequent checkrein deformities in the setting of talus fractures 5 . On the other hand, Anglen and Gehrke reported entrapment of the FHL tendon from a calcaneus fracture, with no checkrein deformity on physical examination 8 .…”

Section: Discussionmentioning

confidence: 99%

“…The flexor hallucis longus (FHL) tendon courses through the groove between the medial and lateral tubercules of the posterior process of the talus, making it vulnerable to displacement in complex fractures 2 . Two reports in the literature have reported this complication in talar body fractures 5,6 . If left untreated, the FHL can tether to the fracture site resulting in a malreduced talus with subsequent malunion, as well as tenosynovitis and restrictive hallux extension 5,6 .…”

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confidence: 96%

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Posterior Talar Body Fracture With Flexor Hallucis Longus Incarceration

McLaughlin

Moran

Brand

et al. 2021

JBJS Case Connector

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Case: A 58-year-old man presented with entrapment of the flexor hallucis longus (FHL) tendon between fractured fragments of the talar body. The patient was successfully treated with atypical operative approaches to release the tendon and reduce the fracture. At the 1-year follow-up, the patient remained asymptomatic with the ability to extend and flex of all toes. This case illustrates a unique surgical approach for this presentation. Conclusions: With proper utilization of positioning and fluoroscopy, posterior talar body fractures with entrapment of the FHL can be stabilized and corrected with dual use of medial-sided approaches.

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“…13 15 Checkrein deformities have also been described in talar fractures and in one reported case of an open lateral subtalar joint dislocation. 16,17 To our knowledge this is the first case that describes an open TTD with a checkrein deformity of the hallux without extrusion of the talus. This case presents two uncommon deformities, their acute management as well as the long term follow up.…”

Section: Introductionmentioning

confidence: 87%

An open total talar dislocation with a checkrein deformity of the hallux without extrusion of the talus: a case report and literature review

Liette¹,

Bazeed²,

Fadel³

et al. 2022

Foot & Ankle Surgery: Techniques, Reports & Cases

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Open total talar dislocations without extrusion of the talus and checkrein deformity of the hallux are both rare injuries of the lower extremity and have never been reported in conjunction to our knowledge. We present a fouryear follow-up of a twenty-four-year-old male who sustained an open pantalar dislocation, without a talus fracture, who simultaneously developed an associated checkrein deformity secondary to entrapment of the flexor hallucis longus. The initial management, sequelae of the injury, and long-term outcome, along with a review of the literature for this uncommon injury is discussed in detail. Due to the rarity of this type of injury, little is known about optimal treatment and long-term outcomes. This case study and literature review may provide more information on anticipated outcomes and complications following this rare injury.

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Checkrein Deformity Associated with Intra-Articular Talar Fracture

Abstract: Physicians should suspect the entrapment of the FHL tendon in cases of flexion deformity of the hallux associated with talar fracture. Proper examination of the forefoot when a patient presents with a hindfoot injury will help to avoid missing such deformities.

Cited by 7 publications

References 10 publications

Closed Pantalar Dislocation With Checkrein Deformity: A Unique Case Report and Literature Review

Closed Pantalar Dislocation With Checkrein Deformity: A Unique Case Report and Literature Review

Posterior Talar Body Fracture With Flexor Hallucis Longus Incarceration

An open total talar dislocation with a checkrein deformity of the hallux without extrusion of the talus: a case report and literature review

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