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Updated: Sep 18, 2025

Simultaneous Quantification of T-Cell Receptor Excision Circles TRECs and K-Deleting Recombination Excision Circles KRECs by Real-time PCR
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Checkrein Syndrome.

Kaitlyn J Loesel1, Anthony J Brando1, Timothy Ford1

  • 1*Podiatric Medicine and Surgery, Department of Orthopedics, University of Louisville, Louisville, KY.

Journal of the American Podiatric Medical Association
|June 26, 2025
PubMed
Summary

Checkrein syndrome, affecting the flexor hallucis longus tendon, can result from trauma or surgery. Lengthening this tendon is an effective treatment, as demonstrated in two cases with different causes.

Area of Science:

  • Orthopedics
  • Foot and Ankle Surgery
  • Tendon Disorders

Background:

  • Checkrein syndrome is a rare condition involving the flexor hallucis longus (FHL) tendon.
  • It presents as hallux malleus during ankle dorsiflexion, improving with plantarflexion.
  • Etiologies include surgical complications or trauma.

Purpose of the Study:

  • To describe two cases of checkrein syndrome with distinct etiologies.
  • To highlight the successful treatment of checkrein syndrome via FHL tendon lengthening.

Main Methods:

  • Case series describing two patients with checkrein syndrome.
  • Etiologies included a pilon fracture and a gunshot wound to the leg.
  • Treatment involved flexor hallucis longus tendon lengthening.

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Main Results:

  • Both cases of checkrein syndrome were successfully treated with FHL tendon lengthening.
  • One patient required a hallux interphalangeal joint arthrodesis in addition to tendon lengthening.
  • Symptomatic relief and functional improvement were achieved.

Conclusions:

  • Flexor hallucis longus tendon lengthening is a primary and effective treatment for checkrein syndrome.
  • This surgical approach can successfully manage checkrein syndrome regardless of etiology.
  • Further investigation into optimal surgical techniques may be warranted.