Repair of ruptured extensor hallucis longus tendon with a semitendinosus tendon allograft: A case report

Abstract

Lacerations leading to rupture of the extensor hallucis longus (EHL) can occur, subsequently leading to an attenuated or fully dysfunctional tendon. Primary repair can be performed if the tendinous ends are in close enough proximity for reattachment. Nonetheless, utilization of a tendon graft or tendon transfer may be advantageous in restoring EHL function. Depending on the environmental setting, injuries to the foot caused by animals are relatively common. For purposes related to our case report, we will focus our attention on stingrays. Stingrays reside in temperate coastal areas and live on the bottom of the ocean. Injuries due to stingrays frequently occur after a defensive strike to the lower extremity when an individual steps on the fish. Consequences of stingray attacks may include embedded fragments, subsequent infection, envenomation, and skin lacerations. In this article, we describe a case of a 69-year-old male who reported to the podiatry clinic after suffering a stingray strike to his left foot, which left him with a dysfunctional left great toe and the inability to dorsiflex. The purpose of our report was twofold: to increase awareness and knowledge of animal-related injuries of the foot, including options for treatment, and to describe a rare case of a repaired EHL tendon using a semitendinosus tendon allograft. To our knowledge, the use of a semitendinosus allograft has not been reported. We describe the use of this free tendon allograft for the primary repair of a ruptured EHL tendon in one patient.