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Flexor hallucis longus tenosynovitis - anatomy and clinical behavior

Pr. Penev, M. Burnev, D. Raykov, K. Ganchev


Background: The flexor hallucis longus (FHL) originates from the posterior border of the fibula and interosseous membrane of the leg. It passes through the retinacular structures at the postero-medial ankle (tarsal canal) which is the most frequent location for its inflammation when happen, due to the excessive amount of friction between calcaneus and synovial sheet of the tendon in this region. Tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in dancers and athlets. This soft tissue ankle impingement is presented by posterior medial ankle pain or great toe discomfort and is often associated with a catching sensation of the great toe. There are a wide variety of open procedures for treatment of FHL tenosynovitis.Objective: Arthroscopic treatment may circumvent some of the complications associated with open surgical treatment of the hindfoot.Methods: The ankle is approached through standard posterolateral and posteromedial portals. A 4.0-mm-diameter 30° arthroscope is used.Results: Arthroscopic release of the FHL tendon sheath is a useful and easy method to directly approach the dynamic pathology of FHL tenosynovitis in dancers and athlets.



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About The Authors

Pr. Penev

M. Burnev

D. Raykov

K. Ganchev

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