Dropped hallux due to denervation of the extensor hallucis longus is a rare, usually transient complication seen after intramedullary nailing of the tibia and occurs in less than one percent of patients. This condition presents as either isolated extensor hallucis longus weakness or a complete loss of dorsiflexion of the hallux. The etiology is largely unknown, however it has been postulated that there could be a subclinical anterior compartment syndrome causing neuromuscular dysfunction. Though research is limited, one study suggests this phenomenon is more common in younger patients1. Here we review 2 cases of post-intramedullarynailing dropped hallux in 2 male patients ages 16 and 17 which have persisted after reduction despite the absence of known risk factors or perioperative complications. More reporting of this complication will hopefully lead to better understanding and prevention.
Gonzalez, Derek and Hosseinzadeh, Pooya
"Two Cases of Persistent Dropped Hallux after Intramedullary Nailing of Tibial Fractures in Pediatric Patients,"
Florida Medical Student Research Journal: Vol. 2
, Article 4.
Available at: http://digitalcommons.fiu.edu/fmsrj/vol2/iss1/4