Checkrein Deformity Research Articles

Checkrein deformity due to extensor hallucis longus hypotrophy treated with extensor digitorum longus tendon transfer.

Checkrein deformity is a relatively rare condition caused by hypotrophy or adhesion of a tendon after a lower leg injury. The occurrence of this condition due to the dysfunction of the extensor hallucis longus (EHL) is extremely rare. Only a few related case reports have been published, and Z-lengthening of the EHL tendon was performed for almost all patients. We report a case of checkrein deformity due to EHL hypotrophy. The patient was involved in a traffic accident 7 years ago. He sustained left tibial and fibular closed diaphyseal fractures and underwent minimally invasive plate osteosynthesis. He continued to have left great toe symptoms characterized by dorsiflexion of the great toe during ankle plantarflexion. The EHL had become an insufficient power source because of considerable hypotrophy. Therefore, a tendon transfer using the extensor digitorum longus to the second toe was performed as a primary treatment.

Outcome of modified Bunnell′s procedure in the management of leprotic claw hand deformity

Clawing, partial or total due to leprosy affects greatly, hand's ability for fine movements, grip and skilful use along with loss of tactile sensation of hand, which usually precedes the motor weakness. We reviewed and evaluated the functional results of Modified Bunnel's procedure in management of 20 patient of leprosy with 28 claw hand deformity. After mean followup of 18 months (range 12-38 months) results were excellent in 10 (35%) cases, good in 12 (42.8%), fair in 4 (14.2%) and poor in 2 (7.1%). 97% of the patients (27/28) had improvement in the grip except one case (3%). Swan-neck deformity, flexion contracture, check-rein deformity and insufficient finger flexion was seen in none of the cases whereas superficial minus deformity of ring finger was seen in only 1 case. Modified Bunnel's procedure is simple to perform and gives superior results as it gives least possible adhesions, provides straight course for the tendon and good leverage with normal angle, with better cosmetic results and patient satisfaction.

Checkrein Deformity by Incarcerated Posterior Tibial Tendon and Displaced Flexor Hallucis Longus Tendon following Ankle Dislocation - A Case Report -

271 통신저자:배 서 영 서울시 노원구 상계6, 7동 761-1 인제대학교 상계백병원 정형외과 족부ᆞ족관절센터 Tel:02-950-1399, 1032ᆞFax:02-950-1398 E-mail:sybae99@gmail.com 접수: 2011. 3. 2 심사 (수정): 2011. 4. 8 게재확정: 2011. 4. 28 Address reprint requests to:Su-Young Bae, M.D., Ph.D. Foot & Ankle Center, Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University, 761-1, Sanggye 6,7-dong, Nowon-gu, Seoul 139-707, Korea Tel:82-2-950-1399, 1032ᆞFax:82-2-950-1398 E-mail:sybae99@gmail.com 족관절 탈구 후 후경골건 감돈과 장족무지굴건 이탈에 동반된 Checkrein 변형 증례 보고 -

Checkrein Deformity Secondary to Entrapment of FHL After Talus Fracture: A Case Report

Level of Evidence: V, Expert Opinion

Contracture of Extensor Hallucis Longus Tendon Occurring after Intramedullary Nailing for a Tibial Fracture

Toe deformities occurring after tibial shaft fracture can result from compartment syndrome or adhesion of muscle to tendon. Claw toes or checkrein deformity caused by injury of posterior compartment muscles has been reported relatively often. But, a deformity due to injury of the anterior compartment muscles is very rare. We observed the two cases of an extension deformity at the metatarsophalangeal joint of the hallux following intramedullary nailing of a tibial shaft fracture. There was no evidence of compartment syndrome. Extension deformity of the hallux was decreased with dorsiflexion of the ankle and increased with plantar flexion. Contracture of the extensor hallucis longus tendon was diagnosed, and Z-lengthening of that tendon was performed. Satisfactory results were obtained without a recurrence of deformity. We report these rare cases of toe deformities occurring after a tibial shaft fracture, with a brief review of the literature.

Arteriovenous Malformation Infiltrating the Extensor Hallucis Longus Tendon

Arteriovenous malformations are defined as congenital lesions of vascular origin with multiple large feeding arteries. When these lesions become symptomatic, they can adversely affect the surrounding soft tissues and osseous structures1,2. Surgical resection with or without embolization therapy is commonly used to treat localized symptomatic arteriovenous malformations. Total surgical resection is necessary to prevent recurrence but may sometimes produce challenging anatomic defects and expose important structures such as bone, joints, tendons, and neurovascular bundles3. Here, we describe an arteriovenous malformation that infiltrated the extensor hallucis longus tendon, resulting in a checkrein deformity of the great toe. The segmental defect of the extensor hallucis longus was reconstructed with use of a tendon graft consisting of one-third of the nearby anterior tibial tendon. The patient was informed that data concerning the case would be submitted for publication, and she consented. A thirty-three-year-old woman presented with a painful, slow-growing soft-tissue mass on the anterior aspect of the distal third of the right leg of ten years’ duration. In addition, she had a checkrein deformity of the right great toe of approximately two years’ duration. More specifically, she was unable to flex the great toe plantarward when the ankle was in plantar flexion, and the great toe extended during ankle plantar flexion. No previous treatment had been rendered. She reported no recent history of trauma, and the medical history was otherwise unremarkable. Her general health was excellent. A firm 6 × 4-cm soft-tissue mass was palpable on the anterior aspect of the distal third of the right leg. The mass was slightly mobile and had a nodular, spongy consistency. It was not pulsatile and lacked a bruit or thrill. Radiographs showed a calcific density just underneath the skin on the anterior aspect of the leg 5 cm proximal …

Treatment of checkrein deformity of the hallux

We studied 11 patients with checkrein deformities of the hallux who underwent surgical treatment. Six had lengthening of the flexor hallucis longus tendon by Z-plasty in the midfoot, and five underwent release of adhesions and lengthening of the tendon by Z-plasty at the musculotendinous junction at the fracture site. All six patients who underwent Z-plasty at the midfoot showed complete correction of the deformity without recurrence. Of the five who had release of adhesions and Z-plasty of the tendon at the fracture site, two showed partial and one showed complete recurrence.

Minimally Invasive Percutaneous Plate Fixation for Distal Tibia Shaft Fractures

Purpose: To review the efficiency of the minimally invasive plate fixation technique for distal tibia shaft fractures. Materials and Methods: Between April 1999 and March 2001, 15 patients with distal tibia fractures were treated operatively by minimally invasive percutaneous plate osteosynthesis. There were 10 men and 5 women with an average age of 51 years (range, 20 to 72 years). The patients were followed for an average of 19 months (range, 12 to 30 months). In all patients, the center of fracture was in the distal tibia and either entirely extraarticular or with minimally displaced extension into the ankle joint. The type of fracture was evaluated using the AO/OTA classification. So far as general condition of patients permitted, temporary reduction of fractures with or without passive traction or distractor was performed under intraoperative fluoroscopy. About a 2 cm to 3 cm incision was made in the metaphyseal region proximal or distal to the fracture site, and screws fixation was performed percutaneously. A clinical assessment was evaluated according to Olerud and Molander ankle score. Results: All of the fractures healed with an average time of 15 weeks (range, 10 to 25 weeks). No patient had an angular deformity more than 5 degrees, or shortening of more than 1 cm. All patients had an excellent or satisfactory ankle function. Checkrein deformity was observed in one patient and superficial infections occurred in two, but no patient experienced deep infection or skin necrosis. Conclusion: As compared with conventional open reduction and internal plate fixation, minimally invasive percutaneous plate osteosynthesis technique was found to be an effective method of treating distal tibia fractures, because it facilitates the rehabilitation more rapid patient rehabilitation, and induces osteosynthesis with reduced of the rates of infection and nonunion.

Checkrein deformity of the lesser toes following comminuted fracture of calcaneus : A Case Report

Checkrein deformity of the lesser toes following comminuted fracture of calcaneus : A Case Report

Flexor digitorum superficialis tendon transfer for intrinsic replacement. Long-term results and the effect on donor fingers.

This study is a review of 127 hands in 100 patients in whom one or two FDS tendons were used to correct claw-hand deformity and/or loss of opposition of the thumb. In lumbrical replacement the results were graded as excellent in 16 hands (21%) and good in 43 hands (57%). For opponensplasty the results were excellent in 26 hands (32%) and good in 42 hands (51%). Possible defects that can develop in the donor finger are: swan-neck deformity, flexion posture of the DIP joint, not as part of the swan-neck deformity, check-rein deformity or flexion contracture, and insufficient finger flexion. Of the 158 fingers swan-neck deformity was seen in 15%, DIP flexion in 29%, check-rein deformity in 26% and insufficient finger flexion in 18%. The latter occurred with another defect. In 48 fingers (30%) no defects were observed.