PO 18068 - Treatment of chronic extensor hallucis longus tendon injury using plantaris tendon graft

Abstract

Introduction: Foot extensor tendon injuries account for 1% of all tendon injuries. Extensor hallucis longus (EHL) tendon lacerations are even less common, and studies on the subject are limited to a small number of case reports and series. Objective: The objective of this report is to show the possibility of using the plantaris muscle as a graft option for the reconstruction of the extensor hallucis longus tendon in cases of damage due to chronic injury. Methods: The subject was a 30-year-old male factory worker who had had a laceration in the dorsal region of the right foot for approximately 2 months. He showed a deficit in hallux extension. Given the indication for surgical treatment and due to the distances between the stumps, we chose to use the plantaris muscle as a graft. Results: The patient was evaluated 6 months after surgery, and we observed a satisfactory outcome with improvements in hallux extension and functional gait. Conclusion: We chose the plantaris tendon as a graft because we believe it is easily harvested, has low morbidity at the donor site, has no or minimal loss of function and meets the needs for the desired reconstruction. Because this is a large graft, we solved the problem of the smaller diameter by performing double-band reconstruction. We concluded that the plantaris is a viable option for neglected EHL injuries or rerupture that offers low morbidity with no significant loss of function in the donor region.