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Foot (Edinb). 2009 Dec;19(4):218-21. doi: 10.1016/j.foot.2009.02.002. Epub 2009 Mar 10.

Arthroscopic release of flexor hallucis longus tendon using modified posteromedial and posterolateral portals in the supine position.

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  • 1Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

The flexor hallucis longus (FHL) is a known site of pathological conditions. FHL stenosing tenosynovitis presents as posterior medial ankle pain or great toe discomfort and is often associated with a catching sensation of the great toe. There are a wide variety of open procedures for the treatment of FHL stenosing tenosynovitis.

OBJECTIVE:

Arthroscopic treatment may circumvent some of the complications associated with open surgical treatment of the hindfoot.

METHODS:

Arthroscopic surgery was completed in the supine position using modified posteromedial and posterolateral portals. A 70 degrees arthroscope allowed for circumferential evaluation of the ankle through the posterolateral portal including the subtalar areas and the entire FHL tendon for release using basket forceps and a 3.5mm shaver.

RESULTS:

This method allows for decompression of the FHL from the entrance of the fibro-osseous tunnel to the knot of Henry. Active and passive range of motion of both the ankle and toes was encouraged postoperatively. The patient returned to sporting activity 6 weeks after surgery.

CONCLUSIONS:

Endoscopic treatment of the FHL stenosing tenosynovitis is presented as an alternative to an open surgical procedure; it may reduce wound complications and may allow for an earlier return to sport.

[PubMed - indexed for MEDLINE]
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