M. Flexor Hallucis Longus Tendon Reconstruction With M. Plantaris Graft – A Case Description and Rehab Program

Abstract

Isolated m.FlexorHallucis Tendon (FHL) rupture is rare and uncommon. We looked for information on the topic of reconstruction of m.flexorhallucis longus and subsequent rehabilitation in the scientific databases of SCOPUS, Elsevier and Google Scholar, but the information found was scarce and partial. This provoked us to share our experience in surgical treatment and subsequent recovery from this type of injury. Case description and patient's information: The considered clinical case concerns a 46-year-old woman with the inability to actively bend the big toe and altered sensitivity of the foot and its plantar surface. Ligamentotomyin the area of the tarsal canal and decompression of the n.tibialis sin was performed surgically. A thorough gentle debridement was performed in the tarsal canal with tenoplasty of the flexor halluces longus with a graft of m. plantaris. Therapeutic intervention: The physiotherapy program was divided into three periods: I (1-6) postoperative week, II (6-12th) postoperative week and III (12-24th) postoperative week. Follow–up and outcomes: The patient was tested three times - on the third postoperative day, at the end of the 12th and at the end of the 24th postoperative week. The test battery included centimetry, goniometry, visual analogue scale (VAS), and manual muscle testing. Conclusion: Based on the difference in the values of the studied indicators in the initial postoperative and final results after reconstruction of FHL with plantar graft and postoperative rehabilitation, we believe that this combination of surgical technique and subsequent physiotherapy protocol is highly effective, with excellent functional outcome.