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Case Reports in Orthopedics
Volume 2015, Article ID 823107, 4 pages
Case Report

Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

1Centro Artroscópico Jorge Batista, 2446 Pueyrredón Avenue, 1st Floor, 1119 Buenos Aires, Argentina
2Favaloro Foundation, 461 Solis Street 1st floor, 1078 Buenos Aires, Argentina
3Human and Embriology Unit, Department of Experimental Pathology and Therapeutics, University of Barcelona, Spain
4Hospital Quirón Barcelona, Plaça d’Alfonso Comín, 08023 Barcelona, Spain

Received 12 February 2015; Revised 4 April 2015; Accepted 12 April 2015

Academic Editor: Quamar Bismil

Copyright © 2015 Jorge Pablo Batista et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.