Extensor hallucis longus tenorrhaphy by using the Massachusetts General Hospital repair

Extensor hallucis longus tendon injury and surgical treatment recommendations are infrequently reported. In contrast to long extensor tendon injuries to the foot, flexor and extensor tendon injuries of the hand have been extensively studied and surgical treatment protocols have been delineated. In biomechanical studies, the Massachusetts General Hospital technique has been shown to have superior strength to other tenorrhaphies and to allow for early active mobilization. The purpose of this study was to examine the use of this technique for repair of extensor hallucis longus tendon injuries to allow for early active motion with minimal risk of rupture. We performed a retrospective review of 6 extensor hallucis longus tendon repairs at the toe level. These patients all regained active motion of the great toe. None had loss of extension. There were no tendon ruptures with this technique of tendon repair. The Massachusetts General Hospital technique can be used to repair the extensor hallucis longus tendon with good functional outcome and minimal risk of tendon rupture.