Functional hallux rigidus in high level athletes: Arthroscopic repair by flexor hallucis longus debridement

Abstract

This study aimed at the surgical technique and long-term clinical outcome of releasing the retrotalar pulley and surgical debulking of the flexor hallucis longus muscle belly to restore motion to the first metatarsophalangeal joint. Hallux limitus is defined as a limitation of motion at the first metatarsophalangeal joint. Numerous etiologies have been described, but most are concentrated within the first ray, especially the first metatarsophalangeal joint. We present a series of patients with hallux limitus caused by impingement of the flexor hallucis longus tendon within the retrotalar pulley due to a hypertrophic and/or low-lying muscle belly. Arthroscopic surgical debridement of the retrotalar pulley and surgical debulking of the flexor hallucis longus muscle belly in the posterior ankle compartment resolved all symptoms at the 1st metatarsophalangeal joint and restored normal motion of the first metatarsophalangeal joint allowing all high level athletes to return to their respective sports with no limitations.