Post-traumatic digital flexion contracture (checkrein deformity)

Abstract

Objective: The aim of this study is to present a series of 8 patients, describing their clinical picture and assessing their treatment using plantar approach. Methods: We retrospectively assessed 8 patients, all of which had a history of trauma. The clinical characteristics of these cases and postoperative results were investigated. Results: Seven men and 1 woman with a mean age of 29 years were included. The follow-up period ranged from 6 to 28 months (mean 22 months). The deformity manifested from 5 to 24 months after the triggering injuries (mean 9.8 months). The hallux was the only digit affected in 1 patient, while the others presented with involvement of 1 or more small toes. There were no postoperative complications, and patients showed to be satisfied with functional outcomes. Conclusion: Post-traumatic digital flexion contracture is an infrequent disease of unknown etiology. Lengthening of the flexor hallucis longus using a plantar approach, whether at the level of the midfoot or the toe, represents an alternative with satisfactory outcomes. Level of Evidence IV; Therapeutic Study; Case Series.

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

“…The shortest reported interval is 2 months. (14) There are various surgical options for correcting the deformity, such as extending the FHL tendon at midfoot on the site of the Henry knot. (1,11) The cause in the present case was a trivial injury, namely a contusion, which resulted in progressive plantarflexion (clawing) of the right great toe and second toe, and progressed into scarring followed by fibrosis and adhesion, thus presumably further leading to a loss of tendon elasticity requiring surgical intervention.…”