Department of Orthopedic Surgery, Osaka Medical and Phamaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Japan.
Foot (Edinb). 2021 Jun;47:101802. doi: 10.1016/j.foot.2021.101802. Epub 2021 Apr 15.
Few studies have reported about isolated contracture in the extensor hallucis longus (EHL) muscle, but none of the EHL muscle contracture after distal tibial physeal injury. Two such cases in 16- and 14-year-old boys who underwent surgeries for distal physeal injury of the tibia at a previous hospital are presented. Extension contracture of the hallux appeared 1-2 months post-surgery. Physical examinations revealed that the extension contracture of the first metatarsophalangeal joint was aggravated in plantar flexion of the ankle due to a tenodesis effect, and magnetic resonance imaging showed atrophy and signal changes in the anterior compartment muscles. This was diagnosed as EHL muscle contracture due to anterior compartment syndrome (ACS) after distal tibial physeal injury. The EHL tendon transfers were performed in both cases, with favorable short-term results. Therefore, the EHL tendon transfer might be preferable in case of the EHL muscle contracture due to partial ACS.
少数研究报告了孤立性拇长伸肌（EHL）挛缩，但胫骨远端干骺端损伤后未见 EHL 肌肉挛缩。本文报告了 2 例 16 岁和 14 岁男孩，他们在另一家医院接受了胫骨远端干骺端损伤的手术。术后 1-2 个月出现踇趾伸展挛缩。体格检查发现，由于腱固定效应，踝关节跖屈时第一跖趾关节伸展挛缩加重，磁共振成像显示前间隔肌肉萎缩和信号改变。这被诊断为胫骨远端干骺端损伤后前间隔综合征（ACS）导致的 EHL 肌肉挛缩。在这 2 例中均进行了 EHL 肌腱转移，短期效果良好。因此，对于部分 ACS 导致的 EHL 肌肉挛缩，EHL 肌腱转移可能是更好的选择。
