Closed atraumatic complete rupture of the flexor halluces longus tendon during forward lunge exercise: A case report
- Abstract
- Rationale: Acute rupture of the flexor halluces longus (FHL) tendon due to trauma or laceration is a well-known phenomenon.
Partial rupture of the FHL tendon caused by tendinitis or stenosing tenosynovitis is common in ballet dancers and athletes. However,
atraumatic complete rupture of the FHL is rare: as of 2018, only 7 cases of closed atraumatic complete rupture of the FHL tendon
have been reported in the literature. Here, we report on a patient who presented with a closed atraumatic complete rupture of the FHL
tendon during a forward lunge exercise.
Patient concerns: A 35-year-old female visited the clinic with pain in the plantar medial aspect of the left foot, along with
weakness and loss of great toe flexion. The patient had a normal foot structure and no history of trauma or systemic disease. She
performed a forward lunge exercise more than 50 times on 1 leg per day, more than once a week to strengthen her leg muscles. She
reported that she felt a slight pain in her left, great toe while exercising for 3 weeks prior to her visit. One week prior to presentation,
severe pain occurred suddenly when her left hallux dorsiflexed strongly during an anterior lunge exercise motion.
Diagnosis: Magnetic resonance imaging revealed complete rupture of the FHL tendon near the level of the metatarsal head and
neck junction. The lesion was prolonged, with the proximal end displaced to the metatarsal shaft region.
Interventions: Complete rupture of the FHL tendon was treated with a primary suture.
Outcomes: At the 1-year follow-up, active plantar flexion of the interphalangeal joint was possible but joint function had a range of
0° to 25°. Flexion strength was reduced slightly, measuring about 70% when compared to the contralateral side, but flexion strength
of the metatarsophalangeal joint was normal.
Lessons: We describe an extremely rare case of complete rupture of the FHL tendon at the level of metatarsal head and neck
junction. It should be understood that this injury can occur not only in professional athletes but also in the general public, and we
recommend educating personal trainers on how to prevent it.
- All Author(s)
- D. I. Chun
; H. S. Lee
; S. H. Won
; S. I. Moon
; K. J. Jung
; J. H. Seo
; H. K. Cho
; D. W. Lee
; A. Ryu
; Y. Manggala
; W. J. Kim
- Issued Date
- 2019
- Type
- Article
- Keyword
- closed atraumatic tendon rupture; flexor hallucis longus tendon; foot; forward lunge
- Publisher
- Lippincott Williams & Wilkins
- ISSN
- 0025-7974
; 1536-5964
- Citation Title
- Medicine
- Citation Volume
- 98
- Citation Number
- 50
- Citation Start Page
- e18409
- Citation End Page
- e18409
- Language(ISO)
- eng
- DOI
- 10.1097/md.0000000000018409
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2416
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