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A Hyperflexion Hallux Mallet Injury: A Case Report.
Gky Tan1, Msj Chew2, S Sajeev3
1Department of Medicine, Lee Kong Chian School of Medicine, Singapore.
Malaysian Orthopaedic Journal
|August 22, 2022
Summary
Closed traumatic ruptures of the extensor hallucis longus (EHL) tendon, or hallux mallet injuries, are rare and often missed. Early diagnosis with imaging and surgical repair leads to excellent functional recovery.
Area of Science:
- Orthopedics
- Sports Medicine
- Traumatology
Background:
- Injuries to the extensor hallucis longus (EHL) tendon are uncommon, typically resulting from lacerations or penetrating trauma.
- Closed ruptures, termed 'hallux mallet injuries,' can be bony or soft, depending on associated fractures at the distal phalanx insertion site.
Observation:
- A 33-year-old female presented with a hyperflexion injury to the left big toe, resulting in an inability to extend it.
- Ultrasound revealed a complete EHL tendon rupture with proximal retraction.
- The patient underwent surgical repair using transarticular pinning and a suture anchor device.
Findings:
- Postoperative recovery at six months demonstrated symmetrical EHL strength and complete range of motion.
- The case highlights the rarity of isolated hallux mallet injuries and their potential for misdiagnosis without penetrating wounds.
Implications:
- Prompt investigation of suspected hallux mallet injuries using imaging modalities like ultrasound or MRI is crucial.
- Surgical intervention is recommended for optimal outcomes in cases of isolated EHL tendon rupture.
