Isolated Extensor hallucis longus paralysis after interlocking tibia A case report

Interlocking nailing is commonly done for tibia diaphyseal fractures. Extensor hallucis longus paralysis is a rare complication following nailing for tibial fracture and rarely reported .This is a case report of such complication. Following road traffic accident, our patient developed closed right tibial and fibular fracture. After a delay of five days interlocking nailing was done .Postoperatively patient developed extensor hallucis longus weakness (MRC grade 0) leading to dropped hallux with sensory deficit in first dorsal web space in right foot without involvement of tibialis anterior and extensor digitorum longus or any other muscle of right leg. Nerve conductioan study confirmed peroneal nerve dysfunction. Electromyogram confirmed the involvement of extensor hallucis longus sparing other muscles of anterior or any other compartment of right leg. Patient showed improvement in grade of muscle power to MRC grade 3 at 4 months with sensory improvement. Patient did not have any functional disability needing surgical correction