Chinzei Nobuaki, Kanzaki Noriyuki, Nagai Kanto, Haneda Masahiko, Yamamoto Tetsuya, Kuroda Ryosuke
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Hyogo Rehabilitation Center, Kobe, 651-2181, Japan.
J Orthop Case Rep. 2021 Apr;11(4):70-74. doi: 10.13107/jocr.2021.v11.i04.2158.
Stenosing tenosynovitis is a chronic disorder frequently observed in finger triggering of a digit. Regarding the toes, although entrapment of the flexor hallucis longus (FHL) has already been reported in a few cases among sports players, the clinical condition is uncommon. Besides, the case without any specific causes is particularly rare.
We report the case of a 26-year-old male with FHL entrapment. Even though he was unaware of any cause, he felt tenderness on the posteromedial side of his left ankle, and his great toe was locked in the flex position. Magnetic resonance imaging indicated effusion in the tendon sheath of the FHL and the possibility of a partial tear of the FHL. We hypothesized that the scar tissue secondary to the partial tear of the FHL may have been irritated at the retrotalar pulley below the sustentaculum tali, where the FHL glides. Therefore, posterior ankle arthroscopy was performed for the treatment of the FHL entrapment.
Orthopedic surgeons should list this pathology as a differential diagnosis of posterior ankle pain, even in non-athletes.
狭窄性腱鞘炎是一种在手指扳机指中常见的慢性疾病。关于脚趾,虽然已有少数运动员出现拇长屈肌(FHL)卡压的报道,但这种临床情况并不常见。此外,无任何特定病因的病例尤为罕见。
我们报告一例26岁男性FHL卡压病例。尽管他未意识到任何病因,但他感到左踝后内侧疼痛,且拇趾锁定在屈曲位。磁共振成像显示FHL腱鞘积液以及FHL部分撕裂的可能性。我们推测FHL部分撕裂继发的瘢痕组织可能在FHL滑动的距骨后滑车处,即载距突下方受到刺激。因此,进行了后踝关节镜检查以治疗FHL卡压。
骨科医生应将这种病理情况列为后踝疼痛的鉴别诊断之一,即使在非运动员中也是如此。