Abstract
The checkrein deformity describes tethering of the flexor hallucis longus tendon, which mainly occurs after fracture of the distal tibia. The deformity increases with dorsiflexion of the ankle and decreases or disappears with plantarflexion of the ankle. In some cases, the deformity may occasionally include the second and third toes. In the current study, the authors experienced secondary checkrein deformity of all lesser toes after open reduction and plate fixation for comminuted fracture of the calcaneus. As a treatment, plate and screws were removed, followed by an additional medial incision which showed a partially ruptured flexor digitorum longus tendon with severe adhesion. Resection of the adhesed tendon and tenodesis of its distal portion to the flexor hallucis longus was performed for correction of the checkrein deformity. Then the lessor toe checkrein deformity recovered immediately. The authors report on this rare lessor toe checkrein deformity after calcaneal fracture fixation with a review of literature.
REFERENCES
1.Carr JB. Complications of calcaneus fractures entrapment of the flexor hallucis longus: report of two cases. J Orthop Trauma. 1990. 4:166–8.
2.Sanhudo JA., Lompa PA. Checkrein deformity--flexor hallucis tethering: two case reports. Foot Ankle Int. 2002. 23:799–800.
3.Rosenberg GA., Sferra JJ. Checkrein deformity--an unusual complication associated with a closed Salter-Harris type II ankle fracture: a case report. Foot Ankle Int. 1999. 20:591–4.
5.Leitschuh PH., Zimmerman JP., Uhorchak JM., Arciero RA., Bowser L. Hallux flexion deformity secondary to entrapment of the flexor hallucis longus tendon after fibular fracture. Foot Ankle Int. 1995. 16:232–5.
6.Bae SY., Chung HJ., Kim MY. Checkrein deformity by incarcer-ated posterior tibial tendon and displaced flexor hallucis longus tendon following ankle dislocation: a case report. J Korean Fract Soc. 2011. 24:271–6.
7.Feeney MS., Williams RL., Stephens MM. Selective lengthening of the proximal flexor tendon in the management of acquired claw toes. J Bone Joint Surg Br. 2001. 83:335–8.
8.Kim SH., Lee KT., Smith RW., Park YU. Checkrein deformity secondary to entrapment of FHL after talus fracture: a case report. Foot Ankle Int. 2010. 31:336–8.