Checkrein Deformity of the Great toe Managed by Midfoot Flexor Hallucis Longus Z-Plasty: A Case Report

INTRODUCTION: Checkrein deformities are rare and involve entrapment or fixed tethering of the flexor hallucis longus (FHL) tendon. CASE REPORT: We present the case of a 25-year-old male who presented with complaint of clawing of his great toe. A history of previous open reduction internal fixation for distal tibia fracture was described 3 years back. Exploration of FHL tendons was performed at the level of the midfoot. Correction was achieved after z-plasty of FHL tendon. This case highlights another late complication of distal tibial fracture which should be actively looked for in patients with this injury. We describe the ease of surgical correction through an operative field free of scar tissue as compared to classical method of operating near fracture site and releasing adhesions of muscle belly. CONCLUSION: We suggest that exploration at the midfoot should be the primary surgical intervention in similar cases of checkrein deformity.