Our Summary

Checkrein deformity (CD) is a condition where the big toe becomes bent due to injury or lack of blood flow, causing the tendon in the toe to shrink. This condition is usually caused by injuries to the leg, ankle, or foot. Diagnosing CD involves physical examination and imaging, like X-rays, to check for other potential causes and monitor the healing process of any fractures.

This study aimed to look at how well patients with CD responded to a particular surgical treatment called the retro-malleolar Z-plasty, which involves lengthening the shrunken tendon. The researchers looked at patients who had this surgery between January 2016 and August 2020.

The researchers found that, out of the 14 patients they studied (average age 37.4 years old), all showed significant improvements in terms of pain relief and better toe joint function. On average, patients noticed the issue with their toe about 7 months after their initial injury. The patients were followed up for an average of 31.8 months after their surgery.

The results were promising, as no patients experienced relapse, loss of strength, nerve injury or developed tarsal tunnel syndrome (a condition caused by a pinched nerve in the ankle). Moreover, no patient required additional surgery.

In conclusion, this study suggests that the retro-malleolar Z-plasty is a good surgical option for treating CD, as it helped patients recover well both clinically and functionally.

FAQs

  1. What is Checkrein deformity (CD) and what causes it?
  2. How is the retro-malleolar Z-plasty procedure beneficial for patients with Checkrein deformity?
  3. What were the results of the study on the effectiveness of the retro-malleolar Z-plasty procedure on patients with CD?

Doctor’s Tip

A helpful tip a doctor might tell a patient about z-plasty is to follow post-operative care instructions carefully to ensure proper healing and to attend all follow-up appointments to monitor progress and address any concerns. It is also important to keep the surgical site clean and dry, avoid putting pressure on the area, and engage in any recommended physical therapy exercises to promote optimal recovery. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support overall healing and prevent future issues.

Suitable For

Patients with Checkrein deformity who have not responded well to conservative treatments such as physical therapy or splinting may be recommended for a retro-malleolar Z-plasty surgery. This surgical option may be especially beneficial for patients who are experiencing pain, limited range of motion, or difficulty walking due to their condition. Additionally, patients who have a history of injuries to the leg, ankle, or foot that have led to the development of CD may also be good candidates for this type of surgery.

Timeline

Before Z-plasty:

  • Patient experiences checkrein deformity in the big toe due to injury or lack of blood flow
  • Diagnosed through physical examination and imaging like X-rays
  • Patients may experience pain, limited range of motion, and difficulty walking

After Z-plasty:

  • Surgery performed to lengthen the shrunken tendon in the toe
  • Patients show significant improvements in pain relief and toe joint function
  • Patients followed up for an average of 31.8 months post-surgery
  • No relapse, loss of strength, nerve injury, or tarsal tunnel syndrome reported
  • No additional surgery required
  • Study suggests that retro-malleolar Z-plasty is an effective surgical option for treating checkrein deformity

What to Ask Your Doctor

Some questions a patient should ask their doctor about Z-plasty for Checkrein deformity include:

  1. What is the success rate of Z-plasty for treating Checkrein deformity?
  2. What are the potential risks and complications associated with Z-plasty surgery?
  3. What is the recovery process like after Z-plasty surgery?
  4. How long will it take to see improvements in pain and toe joint function after Z-plasty?
  5. Are there any alternative treatments for Checkrein deformity that I should consider?
  6. How many surgeries of this type have you performed, and what is your experience with Z-plasty for Checkrein deformity?
  7. Will I need physical therapy or rehabilitation after Z-plasty surgery?
  8. Are there any specific precautions or lifestyle changes I should make after Z-plasty surgery to ensure optimal healing?
  9. How long do the results of Z-plasty surgery typically last for patients with Checkrein deformity?
  10. What is the long-term outlook for patients who undergo Z-plasty for Checkrein deformity?

Reference

Authors: Polichetti C, Greco T, Inverso M, Maccauro G, Forconi F, Perisano C. Journal: Medicina (Kaunas). 2022 Aug 10;58(8):1072. doi: 10.3390/medicina58081072. PMID: 36013539