Year: 2024
Type: article
Abstract: Checkrein deformity is an uncommon dynamic status of the hallux characterized as an aggravation of interphalangeal flexion by ankle dorsiflexion and relief of the deformity by ankle plantarflexion.1) The origin of the word "checkrein" comes from the way the horseman controls the horse, where "check" means to control and "rein" refers to a ring-shaped device that fits into the horse's mouth.When the horseman pulls the rope, the horse's neck is pulled, the morphology of which is similar to that of the flexed hallux when the ankle is dorsiflexed.Clawson first described the observation of claw toes following a tibial fracture.2) The flexor hallucis longus (FHL) tendon often adheres to the callus or scar tissue of the fracture after trauma.Patients may complain of discomfort when wearing shoes, have a wound on the dorsal area of the toes, or tend to trip.As conservative treatments such as stretching are limited in significantly improving symptoms, surgical treatment is more often used.Although a few case series and case reports have reported the results of surgical treatment, there is a lack of a comprehensive review of checkrein deformities.This review aimed to summarize the overall etiology, relevant clinical anatomy, diagnosis, and treatment of this dynamic deformity described in the literature. ETIOLOGYDue to its rarity, previous studies have introduced individual case reports and small case series.In most cases, checkrein deformities occur secondary to trauma, such as malleolar fracture, 3,4) talus, 5) calcaneus, 6) or lower leg fracture.2,7,8) Previous studies reported that such deformities occur approximately 6 months after trauma.9) In addition, in some cases, deformities can occur after dislocation without fractures.Tanwar et al. 10) reported a rare case of closed lateral subtalar dislocation with checkrein deformity of the hallux due to entrapment of the FHL tendon.Another study reported the occurrence of deformity caused by an incarcerated posterior tibial tendon and displaced FHL tendon following ankle dislocation without fracture.11)
Source: Clinics in Orthopedic Surgery
DOI: 10.4055/cios23229
Authors: Min Gyu Kyung, Yun Jae Cho, Dong Yeon Lee
Language: English
Topic: Foot and Ankle Surgery
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4390987199