Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Management of FHL tendon rupture

Discussion in 'Foot Surgery' started by Mart, Mar 18, 2013.

  1. Mart

    Mart Well-Known Member


    Members do not see these Ads. Sign Up.
    Hi All

    I saw a patient today with US confirmed FHL rupture; approx three weeks post onset of initial pain, no apparent cause, 60YO male no relevent comorbidity.
    Retrocalc pain and swelling largely subsided. Retracted ends on US appeared distal to knot of Henry and proximal to Sust Tali.

    Ambulated without pain and other than loss of active hallux plantarflexion seems unaffected by injury.

    Anyone able to justify need for repair as opposed to neglectful wait?

    Cheers
    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  2. drsarbes

    drsarbes Well-Known Member

    Hi Martin
    Could you tell what level the rupture was?

    I would not bother repairing this...the FHL is often sacrificed in other procedures and patients seem to do fine without it.

    Steve
     
  3. Mart

    Mart Well-Known Member

    Thanks Steve - that makes sense and was my assumption - all I could see was where the retracted ends were so I guess rupture somewhere in between knot of Henry and Sust Tali - I have never come across this before.

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  4. Lee

    Lee Active Member

    Hi Mart,
    There's usually an interconnecting tendon between the long flexors around the site of the knot of Henry. As Steve has already said, either one of the long flexors can be sacrificed in some surgeries (eg. FDL transfer for PTTD or FHL augmentation in Achilles' tendon reconstruction). It's likely that the risk of fixing the tear outweighs the benefits in the case you present.
    Here's an article that you might find interesting:
    http://www.ijav.org/2012/ijav_2012_090-092.pdf
     
  5. Mart

    Mart Well-Known Member

    Thanks for that Lee; interesting and interconnecting tendon not something I had thought about

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  6. Bennepod

    Bennepod Active Member

    Martin.

    I have been functioning with a ruptured FHL for 7 years with no noticeable deficit.
    Sounds very much like the case you describe, just a sharp burning pain at the time ( I was demonstrating high jumping techniques).

    Brendan Bennett
     
  7. Mart

    Mart Well-Known Member

    Hi Brendon

    Hope life is sweet on East Coast :). are you making progress with US learning curve?

    my patient was doing something less exciting than jumping over sticks - he attributed his injury to a long walk wearing clogs which he felt caused excessive activity of toe flexors to stop shoes falling off feet - sounds plausible.

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
Loading...

Share This Page