title: Z-plasty of the flexor hallucis longus tendon at tarsal tunnel for checkrein deformity.
abstract: To review the outcome of Z-plasty of the flexor hallucis longus (FHL) tendon at the tarsal tunnel for checkrein deformity in 8 patients.
  
  
  
  Records of 6 males and 2 females aged 14 to 67 (mean, 39.5) years who underwent Z-plasty (lengthening) of the FHL tendon at the tarsal tunnel for checkrein deformity in the first and second toes by a single surgeon were reviewed. All patients had undergone 3 months of conservative treatment. The mean time from injury to surgical treatment was 8.4 (range, 5-12) months. All patients had associated injuries including distal tibiofibular fracture (n=6), distal fibular fracture (n=1), and crush injury aroundthe ankle (n=1); they were treated with intramedullary nailing (n=6), long leg splinting (n=1), and short leg splinting (n=1).
  
  
  
  After a mean follow-up of 3.4 (range, 1-7) years, the FHL tendon was lengthened by a mean of 1.7 (range, 1.6-1.8) cm, and the mean American Orthopedic Foot and Ankle Society hallux score increased from 59 (range, 52-67) to 89 (range, 80-90). No patient had recurrence, nerve injury, or tarsal tunnel syndrome, although one patient had sensory disturbance of the posterior tibial nerve in the forefoot, which resolved spontaneously at week 2.
  
  
  
  Z-plasty of the FHL tendon at the tarsal tunnel is a viable option for correction of checkrein deformity.
authors.affiliation: Departments of Orthopedic Surgery, Kyung Hee University Hospital at Gangong, School of Medicine, Kyung Hee University, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Departments of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Departments of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Korea.
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Baek
authors.affiliation: Departments of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Korea.
authors.forename: Dong Hee
authors.initials: DH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000150:complications; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D008297:Male; D008683:Metatarsophalangeal Joint; D008875:Middle Aged; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D055815:Young Adult
keywords: foot deformities, acquired; tendons