Endoscopic Tenolysis of Flexor Hallucis Longus Tendon: Surgical Technique

Overview

Journal Arthrosc Tech

Publisher Elsevier

Date 2020 Oct 7

PMID 33024666

Authors

Theresa Rebecca Olden

Jacques Vallotton

Affiliations

Soon will be listed here.

Abstract

Flexor hallucis longus tendon release for surgical treatment of functional hallux limitus-associated conditions is described. This release is obtained by arthroscopic correction of the tendon's blockage, which is located at the retrotalar pulley. The procedure restores the ability for dorsiflexion of the first toe in ankle dorsiflexion (positive stretch test result). Such movement was not possible before, causing a modified gait pattern and affecting the biomechanics of the foot and leg. This explains why the procedure creates favorable changes concerning foot dynamics by restoration not only of the normal tendon glide but also of the normal mobility of the subtalar joint.

References

Vallotton J, Echeverri S, Dobbelaere-Nicolas V . Functional hallux limitus or rigidus caused by a tenodesis effect at the retrotalar pulley: description of the functional stretch test and the simple hoover cord maneuver that releases this tenodesis. J Am Podiatr Med Assoc. 2010; 100(3):220-9. DOI: 10.7547/1000220. View

Galla M, Lobenhoffer P . Technique and results of arthroscopic treatment of posterior ankle impingement. Foot Ankle Surg. 2011; 17(2):79-84. DOI: 10.1016/j.fas.2010.01.004. View

Spennacchio P, Cucchi D, Randelli P, van Dijk N . Evidence-based indications for hindfoot endoscopy. Knee Surg Sports Traumatol Arthrosc. 2016; 24(4):1386-95. DOI: 10.1007/s00167-015-3965-1. View

Dananberg H . Gait style as an etiology to chronic postural pain. Part II. Postural compensatory process. J Am Podiatr Med Assoc. 1993; 83(11):615-24. DOI: 10.7547/87507315-83-11-615. View

Vega J, Redo D, Savin G, Malagelada F, Dalmau-Pastor M . Anatomical variations of flexor hallucis longus tendon increase safety in hindfoot endoscopy. Knee Surg Sports Traumatol Arthrosc. 2017; 25(6):1929-1935. DOI: 10.1007/s00167-017-4465-2. View

Dananberg H . Sagittal plane biomechanics. American Diabetes Association. J Am Podiatr Med Assoc. 2000; 90(1):47-50. DOI: 10.7547/87507315-90-1-47. View

Scheibling B, Koch G, Clavert P . Cadaver study of anatomic landmark identification for placing ankle arthroscopy portals. Orthop Traumatol Surg Res. 2017; 103(3):387-391. DOI: 10.1016/j.otsr.2016.09.026. View

Vallotton J . [Functional hallux limitus (Fhl): a new explanation for overuse pathologies]. Rev Med Suisse. 2015; 10(453):2333-7. View

Dananberg H . Gait style as an etiology to chronic postural pain. Part I. Functional hallux limitus. J Am Podiatr Med Assoc. 1993; 83(8):433-41. DOI: 10.7547/87507315-83-8-433. View

10.

Miyamoto W, Takao M, Matsushita T . Hindfoot endoscopy for posterior ankle impingement syndrome and flexor hallucis longus tendon disorders. Foot Ankle Clin. 2015; 20(1):139-47. DOI: 10.1016/j.fcl.2014.10.005. View

11.

Tzioupis C, Oliveto A, Grabherr S, Vallotton J, Riederer B . Identification of the retrotalar pulley of the Flexor Hallucis Longus tendon. J Anat. 2019; 235(4):757-764. PMC: 6742900. DOI: 10.1111/joa.13046. View

12.

Kennedy J, van Dijk P, Murawski C, Duke G, Newman H, DiGiovanni C . Functional outcomes after peroneal tendoscopy in the treatment of peroneal tendon disorders. Knee Surg Sports Traumatol Arthrosc. 2016; 24(4):1148-54. DOI: 10.1007/s00167-016-4012-6. View

13.

Rungprai C, Tennant J, Phisitkul P . Disorders of the Flexor Hallucis Longus and Os Trigonum. Clin Sports Med. 2015; 34(4):741-59. DOI: 10.1016/j.csm.2015.06.005. View

14.

Monteagudo M, Maceira E, Martinez de Albornoz P . Foot and ankle tendoscopies: current concepts review. EFORT Open Rev. 2017; 1(12):440-447. PMC: 5367565. DOI: 10.1302/2058-5241.160028. View

15.

van Dijk C, Scholten P, Krips R . A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy. 2000; 16(8):871-6. DOI: 10.1053/jars.2000.19430. View

16.

Durrant B, Chockalingam N . Functional hallux limitus: a review. J Am Podiatr Med Assoc. 2009; 99(3):236-43. DOI: 10.7547/0980236. View

17.

Deng D, Hamilton G, Lee M, Rush S, Ford L, Patel S . Complications associated with foot and ankle arthroscopy. J Foot Ankle Surg. 2011; 51(3):281-4. DOI: 10.1053/j.jfas.2011.11.011. View