Mini thigthrope® fixation of unstable bony avulsion of the extensor hallucis longus tendon.

Reports of isolated avulsion fracture of the distal phalanx of the hallux that comprise the functionality of the extensor hallucis longus tendon (EHL) are scarce and treatment for such injury has only been described in isolated single case reports. Two patients with an unstable avulsion fracture of the distal phalanx treated with reinsertion of the EHL with a Mini ThigthRope® system are presented in this paper. Two patients whom suffered an extreme plantarflexion mechanism sought attention in our clinic. Plain x-rays depicted a displaced and angulated bony avulsion fracture of the base of the distal phalanx of the hallux. The interphalangeal joint was in a slightly plantarflexed position and the patient was not able to perform active extension upon request. Surgical fixation performed with Mini ThigthRope® system without transarticular immobilization of the interphalangeal joint. In the two patients the Mini ThigthRope® system provided adequate reduction of the displaced articular fragment, restored the extensor function and allowed early postoperative mobilization of the IP joint. Removal of the implants was not necessary and patients were able to resume their previous activity levels. Level of Evidence: IV.