Dropped Hallux after Interlocking Nailing of Tibial Fractures

Intramedullary nailing is commonly done for Tibial shaft fractures. Between May 2012 and November 2013, we studied prospectively 77 tibial diaphyseal fractures with or without Fibular fracture. All patients were evaluated clinically for any neurological injury preoperatively. All patients were evaluated clinically for any signs of compartment syndrome or any neurological deficit in postoperative period. Patients who had dropped hallux with sensory deficit in first dorsal web space of foot without clinical involvement of Tibialis anterior and Extensor digitorum longus were followed up regularly to assess the improvement in neurological status. Nerve conduction study was done in all patients. Out of seventy seven patients, seven developed dropped hallux. Isolated Extensor hallucis longus (EHL) weakness is an underreported complication following tibial interlocking nailing. This is an iatrogenic injury and can be prevented by minimizing the risk factors.