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Extensor hallucis longus and brevis re-tear

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Right midfoot dorsum cut injury followed by extensor hallucis longus and brevis repair about one month back. Presented with poor great toe extension. Ultrasound to check repaired tendon-muscle continuity.

Patient Data

Age: 20 years
Gender: Male

There are surgical sutures between two edges of the extensor hallucis longus tendon. However, there are no tendon fibers around the sutures that favor a defect in the repaired tendon; measuring about 20 mm in length. Passive toe movement doe not move the tendon proximal to the repair site.

Similarly, there are surgical sutures between two edges of the extensor hallucis brevis muscle. There is a defect of about 7 mm in length. Passive toe movement does not move the muscle proximal to the repair site.

The underlying dorsalis pedis artery is patent.

Case Discussion

A young male had a cut wound to the dorsum of the foot resulting in an extensor hallucis longus tendon and extensor hallucis brevis muscle tear. Surgical repair was done. There was poor great toe extension at one month after the surgery. Ultrasound shows retear of the extensor hallucis longus tendon and the extensor hallucis brevis muscle. Re-repair was done using fascia lata autograft.

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