Use of a palmaris longus graft for the treatment of a chronic rupture of the extensor hallucis longus

Injuries of the extensor hallucis longus (EHL) tendon is relatively rare, but surgical repair is necessary to avoid deformity and gait disorders.
Primary suturing is always the best option when possible; in the case of chronic lesions, retraction makes this solution impossible, necessitating tendon transfer or grafting. We report here the case of a patient with a lacerated suture after primary repair following early mobilization. The patient complained of gait disturbance in the meantime, which led to consultation.
After resumption of the old approach and debridement, a 2cm gap persisted between the two tendon ends. a graft was harvested from the palmaris longus. This time, immobilization was performed using an arthrodesis pin. after removal of the pin and rehabilitation, there was a clear improvement.
The use of the palmaris longus brings the advantage of an adapted diameter which minimizes the phenomena of snagging due to fibrotic projections, and unlike other grafts, avoids affecting another healthy joint.