A New Method of Functional Tendon Transfer for the Dysfunction of Extensor Hallucis Longus

Leung, Yuk‐Man; Ip, Shirley P. S.; Chung, O M

doi:10.1177/107110070202301208

Cited by 30 publications

(18 citation statements)

References 4 publications

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“…The choice for the second-toe extensor tendon and avoidance of other potential donor sites is justified by anatomic adjacency, easy dissection, and no donor site morbidity. 10 The functional results as per the American Orthopaedic Foot & Ankle Society (AOFAS) hallux scale were very good in the first case, with 45 points out of 45 and 35 out of 45 points for the second patient. Both patients presented with normal range of motion of the hallux 6 months after the surgery, with the results graded as good according to Lipscomb and Kelly.…”

Section: Discussionmentioning

confidence: 88%

A Combined Surgical Approach for Extensor Hallucis Longus Reconstruction: Two Case Reports

Duarte

Fradinho

2020

Indian J Plast Surg

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The surgical management of foot tendon injuries is not well-represented in literature. To achieve excellent functional recovery of the extensor hallucis longus (EHL) tendon, we aimed at developing a reliable and feasible reconstructive technique.A surgical technique for delayed reconstruction of the EHL tendon, combining an elongation procedure with second toe extensor tendon transfer, is described in this article.The results of this combined approach for EHL tendon reconstruction were remarkable, since the patients of the two clinical cases reported regained active extension of the hallux after 6 months without any associated complication.This study represents a step forward in foot surgery, since it describes an alternative technique to manage EHL tendon lesions.

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Section: Discussionmentioning

confidence: 88%

A Combined Surgical Approach for Extensor Hallucis Longus Reconstruction: Two Case Reports

Duarte

Fradinho

2020

Indian J Plast Surg

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“…Leung described the use of dynamic transfer of the second toe EDL to the distal stump of the EHL using end-to-end suture or Pulvertalf technique, not exploring the proximal stump, to achieve a functional result. However, this technique does not entirely address the diameter mismatch between the second toe EDL and the EHL (Leung, Ip, & Chung, 2002).…”

Section: Discussionmentioning

confidence: 99%

Extensor hallucis longus tendon and soft‐tissue reconstruction with palmaris longus tendon included in a radial forearm free flap: A case report

et al. 2019

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Reconstruction of foot structures is challenging because of the need to restore both anatomy and function. Extensor hallucis longus (EHL) excision without reconstruction could result in a flexion deformity of the toe at the interphalangeal joint. In this report, we present a case of the use of a palmaris longus tendon included in a fasciocutaneous radial forearm free flap to reconstruct EHL tendon and soft tissues of the distal foot dorsum. A 41‐year‐old woman presented with a recurrence of myxoinflammatory fibroblastic sarcoma on the medial part of the left foot dorsum. The EHL tendon was sacrificed, leaving a soft‐tissue defect of 14 × 5 cm and 14‐cm tendon gap. A 14 × 5 cm radial forearm flap with a 16‐cm section of palmaris longus tendon was harvested from the left forearm. Radial artery and its comitant vein were anastomosed with dorsalis pedis artery and vein. EHL tendon repair was performed from the composite mass to the proximal and distal stumps. No complication in the postoperative period occurred. At latest follow‐up, 12 months postoperatively, the patient showed a normal joint function and was satisfied with the treatment. Palmaris longus tendon included in a radial forearm free flap could be recommended for combined soft tissue and tendon defects, particularly on the foot dorsum.

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“…In cases in which tendon retraction persists after tendon mobilization, or in chronic conditions (≥6 weeks) in which the tendon ends cannot be reapproximated or the tendon ends have become severely degenerated, a tendon graft is the procedure of choice (5,7). Case studies have suggested the use of split EHL tendon lengthening (8), a fascia lata allograft (9), a gracilis autograft (13), and an extensor digitorum longus free tendon graft (16) for such repair. These techniques for reconstruction of the EHL were not appropriate for our patient owing to the large size of the tendon deficit.…”

Section: Discussionmentioning

confidence: 99%

Split Peroneus Longus Free Tendon Autograft Transplantation for the Treatment of Neglected Extensor Hallucis Longus Tendon Laceration: A Case Report

Black

Mehl³

2018

The Journal of Foot and Ankle Surgery

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A neglected laceration of the extensor hallucis longus (EHL) tendon is rare. Retraction of the tendon ends often occurs when a laceration is neglected, leading to a substantial tendon deficit. A paucity of case reports is available describing the treatment of EHL laceration with a large area of gap secondary to retraction. Therefore, the treatment recommendations are limited. We present the case of a neglected EHL tendon laceration with a 10.5-cm gap in a healthy 22-year-old female. The EHL tendon laceration was repaired using a split peroneus longus tendon autograft that, to the best of our knowledge, has not been previously reported. At the 3-year follow-up evaluation, the patient retained full function of her hallux and was free of symptoms.

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A New Method of Functional Tendon Transfer for the Dysfunction of Extensor Hallucis Longus

Abstract: A surgical technique of functional tendon transfer for the treatment of extensor hallucis longus (EHL) rupture is described. By using the extensor digitorum longus tendon of the second toe, the patient regains active dorsiflexion of the big toe and the deformity of the toe is corrected.

Cited by 30 publications

References 4 publications

A Combined Surgical Approach for Extensor Hallucis Longus Reconstruction: Two Case Reports

A Combined Surgical Approach for Extensor Hallucis Longus Reconstruction: Two Case Reports

Extensor hallucis longus tendon and soft‐tissue reconstruction with palmaris longus tendon included in a radial forearm free flap: A case report

Split Peroneus Longus Free Tendon Autograft Transplantation for the Treatment of Neglected Extensor Hallucis Longus Tendon Laceration: A Case Report

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