- 期刊
Checkrein Deformity Following Tibial Fractures a Report of Five Cases
脛骨骨折合併腳趾馬韁狀畸形五病例報告
並列摘要
We present five cases of checkrein [RG1] deformity of the toes after fracture at the lower tibia. The foot symptoms of four male patients and one female patient (18 to 43 years old) developed within 5 months of fracture. They all pre-sented with flexion contracture of the interphalangeal joints of the toes especial-ly the big toes. Plantar flexion of the ankle relaxed and partially corrected the deformity, whereas dorsiflexion increased it. Concomitant claw-toe deformity of the lesser toes was noted in three patients. Three patients complained of numb-ness along medial aspect of ankle and foot, and the NCV/EMG examination of patient 1 confirmed entrapment of posterior tibial nerve. Long incision medial to low tibia was performed and operation findings revealed the tendons of flexor hallucis longus (FHL) and flexor digitorum longus (FDL) were extensively adherent to the adjacent tibia at the fracture site. Tenolysis of FHL and FDL at the musculotendinous junction was performed in all patients and Z-lengthening of FHL was performed in two. Entrapment of the posterior tibial nerve was found in two cases and neurolysis was done. The excursion of the tethered ten-dons improved immediately after the release, and all toe deformities disap-peared. Follow up for at least one year found recurrence of checkrein deformity in two patients, but no further surgical procedures were given.