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Flexor hallucis longus tendon injury in competitive sport athletes

H. Lohrer*, S. Arentz & J. Scholl
Sportmedizinisches Institut Frankfurt/Main, Germany

Introduction: Flexor hallucis longus tendon injury is described as a rare cause of rear foot pain, mainly associated with ballet dancing. This study retrospectively evaluates results of operative treatment of Flexor hallucis longus tendon injury. Material and Methods: Between 1996 und 2001 26 feet in 23 athletes were operated on a chronic Flexor hallucis longus tendon injury in the Sports Medicine Institute Frankfurt am Main (Germany). Follow up was done between 8 and 66 months after surgery using a standardised questionnaire. Main outcome measure was functional and sport specific level as compared to preoperative situation (visual analogue scale). Results: All patients were athletes, but ballet dancers were rare compared to track and field athletes and athletes active in ball sports. Symptoms existed for 13,4 ± 9,8 month preoperatively. Follow up was at 26,7 ± 18,0 month postoperative. Visual analogue scale for sports albility showed significant increase from 2,0 ± 1,6 at baseline to 8,7 ± 1,9 at follow up. There were no deteriorations. Good and very good results could be obtained in 88% of these patients. Discussion: Flexor hallucis longus tendon injury is frequently misdiagnosed. Contrasting to literature athletes from sports, other than ballet are often affected in the presented group. Flexor hallucis longus tendon injury seems to be sport specific, but not ballet dance specific as shown in previous literature. The cause of this injury is a functional mechanic stenosis. Effects of conservative treatment are therefore limited by principle. Operative treatment is successful in most cases suffering from this sport induced overload tendon injury. Unchanged sports performance in the particular sport discipline is obtained surely. But in principle surgery is at risk, because of the neurovascular bundle which runs in close relation to the Flexor hallucis tendon.

All copyright remains with Sports Medicine Australia.

The National Sport Information Centre Web Archive provides access to archive copies of materials in electronic forms. There is no inference that these materials necessarily reflect the current policy of any of the institutions or agencies that created them.