In 2016, the most recent series appeared; it described 40 ankles in 38 dancers who underwent os trigonum excision via an open posteromedial approach with FHL tenolysis
with an excellent result in 95% of the cases and one ballet dancer who, although she returned to ballet and modern dance, was unable to return to her pre-injury level of pointe because of posteromedial scar tissue.
Considering these features, HAM has already been used as a biologic dressing to promote wound healing process and treatment for tissue reconstruction, abdominal adhesiolysis, neurolysis, tenolysis
and injuries of the vagina and dura-matter since more than 100 years ago.
Omentum as a gliding material after extensive forearm tenolysis
has been used in human patients to reduce adhesions .
14,40,41) Tendon adhesions leading to decreased joint range of motion are expected, particularly in zone II repairs and often will require future tenolysis
surgery or staged tendon grafting.
Rupture of FPL tendon was noted in one patient and tenolysis
of FDS was needed in one patient (2.
The plastic surgeons were recommending tenolysis
and wrist arthrodesis, while the orthopedists were recommending watchful waiting for return of sensation.
1,5,6) Several of the aforementioned treatments are invasive and involve risk of radial digital nerve injury, tenolysis
, infection and persistence.
This study is a retrospective case series of 40 ankles in 38 dancers who underwent os trigonum excision via an open posteromedial approach with FHL tenolysis
between 2000 and 2013.
If passive range of motion is maintained with loss of active motion, this is indicative of tendinous adhesions, which can be treated with tenolysis
No ruptures were reported; however, one finger required tenolysis
If the patient has full passive motion, but is lacking active motion, the cause is tendon adhesions, treated with delayed tenolysis
at 3 to 6 months postoperatively.