Functional hallux rigidus in high level athletes: Arthroscopic repair by flexor hallucis longus debridement


  • Brian Carpenter, DPM, FACFAS Professor, Department of Orthopaedics, University of North Texas Health Science Center, Fort Worth, Texas, USA
  • Michael Gentile, DPM, FACFAS Fellowship Director, Portland Foot and Ankle Reconstructive Fellowship; Private Practice: Portland Foot and Ankle Institute, Portland, Oregon, USA
  • Jacob Russell Hagenbucher, DPM, AACFAS Fellow, Portland Foot and Ankle Reconstructive Fellowship, Portland, Oregon, USA



athletes, hallux limitus, flexor hallucis longus, FHL, first metatarsal phalangeal joint, MTPJ, retrotalar pulley, zone 1, impingement


This study aimed at the surgical technique and long-term clinical outcome of releasing the retrotalar pulley and surgical debulking of the flexor hallucis longus muscle belly to restore motion to the first metatarsophalangeal joint. Hallux limitus is defined as a limitation of motion at the first metatarsophalangeal joint.  Numerous etiologies have been described, but most are concentrated within the first ray, especially the first metatarsophalangeal joint.  We present a series of patients with hallux limitus caused by impingement of the flexor hallucis longus tendon within the retrotalar pulley due to a hypertrophic and/or low-lying muscle belly.  Arthroscopic surgical debridement of the retrotalar pulley and surgical debulking of the flexor hallucis longus muscle belly in the posterior ankle compartment resolved all symptoms at the 1st metatarsophalangeal joint and restored normal motion of the first metatarsophalangeal joint allowing all high level athletes to return to their respective sports with no limitations.


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How to Cite

Carpenter B, Gentile M, Russell Hagenbucher J. Functional hallux rigidus in high level athletes: Arthroscopic repair by flexor hallucis longus debridement. J Int Foot Ankle [Internet]. 2021 Dec. 28 [cited 2022 Aug. 14];1(1). Available from: