title: Surgical correction of checkrein deformity after malunited distal tibia fracture: a case report.
abstract: Checkrein deformities are rare and involve entrapment or tethering of the flexor hallucis longus and, occasionally, flexor digitorum longus tendons. The deformity has typically been secondary to traumatic fractures of the talus, calcaneus, or deep posterior compartment syndrome resulting from fractures of the tibia and fibula and most fractures of the ankle. These result in flexion contractures at the interphalangeal joint of the hallux. Because of the rarity of this deformity, no single surgical technique has been defined as the standard. Previous interventions have included release of adhesions with or without Z-plasty lengthening of the involved tendons. The present study reports a case of checkrein deformity secondary to a malunited distal tibia fracture, with flexion deformities to digits 1 through 3. The patient underwent successful surgical correction with flexor tenotomies to the affected digits with interphalangeal arthrodesis to the hallux.
authors.affiliation: Resident, Des Moines Podiatric Residency Program, UnityPoint Health, Des Moines, IA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Holcomb
authors.affiliation: Resident, Des Moines Podiatric Residency Program, UnityPoint Health, Des Moines, IA.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Temple
authors.affiliation: Faculty, Des Moines Podiatric Residency Program, UnityPoint Health, Des Moines, IA; and Attending Physician, The Iowa Clinic, West Des Moines, IA. Electronic address: ebarp@iowaclinic.com.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Barp
authors.affiliation: Faculty, Des Moines Podiatric Residency Program, UnityPoint Health, Des Moines, IA; and Adjunct Clinical Assistant Professor, University of Iowa Carver College of Medicine, Iowa City, IA.
authors.forename: Hayden L
authors.initials: HL
authors.lastname: Smith
mesh_terms: D001174:Arthrodesis; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017759:Fractures, Malunited / Q000150:complications*; D006214:Hallux; D037801:Hammer Toe Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D011859:Radiography; D013708:Tendon Injuries / Q000209:etiology / Q000601:surgery; D058971:Tenotomy; D013978:Tibial Fractures / Q000150:complications*; D014033:Toe Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
keywords: ankle fracture; flexor hallucis longus adhesions; hammertoes; tendinous adhesions