Endoscopic Release of Master Knot of Henry

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Presentation transcript:

Endoscopic Release of Master Knot of Henry Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S. Arthroscopy Techniques Volume 4, Issue 6, Pages e847-e850 (December 2015) DOI: 10.1016/j.eats.2015.08.007 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Zone 1 flexor hallucis longus (FHL) tendoscopy of the right foot. The patient is in the prone position. (A) A Wissinger rod is inserted through the posteromedial portal into the orifice (a) of the zone 2 FHL tendon sheath under arthroscopic guidance. (B) The rod passes through the zone 2 FHL tendon sheath under the sustentaculum tali and penetrates the plantar aponeurosis distal to the navicular bone. The plantar portal incision is made at this point. Arthroscopy Techniques 2015 4, e847-e850DOI: (10.1016/j.eats.2015.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Zone 2 flexor hallucis longus tendoscopy of the right foot. The patient is in the prone position. The arthroscopic shaver is inserted through the plantar portal and passes through the flexor digitorum brevis muscle (a) and the fascial layer deep to the muscle (b) before the master knot of Henry. Fibrosis between the flexor hallucis longus tendon (c) and the flexor digitorum longus tendon (d) is seen. Arthroscopy Techniques 2015 4, e847-e850DOI: (10.1016/j.eats.2015.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Zone 2 flexor hallucis longus tendoscopy of the right foot. The patient is in the prone position. The posteromedial portal is the viewing portal. (A) The arthroscopic shaver or (B) the arthroscopic scissors is inserted through the plantar portal to resect the scar tissue (a) around the flexor hallucis longus tendon (b) and the flexor digitorum longus tendon (c) at the master knot of Henry. Arthroscopy Techniques 2015 4, e847-e850DOI: (10.1016/j.eats.2015.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Zone 2 flexor hallucis longus (FHL) tendoscopy of the right foot. The patient is in the prone position. The posteromedial portal is the viewing portal. The FHL and flexor digitorum longus (FDL) tendons can be clearly seen after resection of the scar tissue at the master knot of Henry. Arthroscopy Techniques 2015 4, e847-e850DOI: (10.1016/j.eats.2015.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions