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Triggering of the great toe. A case report
Clinical Orthopaedics and Related Research
|May 1, 1983
Summary
A 20-year-old athlete experienced great toe pain due to the flexor hallucis longus tendon becoming entrapped. Surgical release of the tendon sheath effectively resolved the triggering and locking symptoms.
Area of Science:
- Orthopedics
- Sports Medicine
- Anatomy
Background:
- The flexor hallucis longus (FHL) tendon is crucial for great toe plantarflexion and propulsion.
- Tendon sheath entrapment can cause pain and functional limitation, particularly in athletes.
- Conservative treatments often fail for FHL tendon entrapment.
Observation:
- A 20-year-old male athlete presented with painful triggering and locking of the great toe.
- Symptoms were localized to the posterior aspect of the left medial malleolus.
- Physical examination revealed no tendon fiber rupture or inflammation.
Findings:
- Open surgical exploration identified an elongated FHL tendon entrapped within its sheath.
- The entrapment occurred posterior to the medial malleolus in the ankle region.
- Histological examination ruled out tendonitis or supernumerary muscle.
Implications:
- Surgical release of the entrapped FHL tendon is an effective treatment for this condition.
- Understanding anatomical variations, like tendon elongation, is key to diagnosing FHL entrapment.
- This case highlights the importance of considering tendon sheath issues in athletic foot pain.