Primary Extensor Hallucis Longus Repair With TeKBrace Augmentation in a Professional Athlete: A Case Report

Abstract

Background

Extensor hallucis longus (EHL) tendon lacerations are relatively uncommon but can have significant functional consequences, particularly in high-demand athletes where dorsiflexion strength, toe-off mechanics, and dynamic foot control are critical for performance. While primary repair remains the standard of care, concerns persist regarding early loading, elongation, and delayed return to sport.

Purpose

To present a case of primary EHL tendon repair augmented with a synthetic reinforcement scaffold (TeKBrace, TheraMicro, LLC) in a professional athlete, highlighting the role of load-sharing constructs in facilitating accelerated rehabilitation and return to high-level function.

Case Presentation

A professional athlete sustained an acute laceration to the EHL tendon. Surgical management consisted of primary end-to-end repair augmented with the TeKBrace scaffold reinforcement designed to provide immediate mechanical support while permitting physiologic motion. Results. The patient progressed through an accelerated rehabilitation protocol with early protected motion. At 6 weeks, the patient demonstrated functional strength and active participation in therapy. Return to sport was achieved at 10 weeks postoperatively without complications.

Conclusion

Augmentation of EHL tendon repair with the TeKBrace scaffold may provide additional mechanical support in high-demand patients by supporting early load-sharing while maintaining native tendon mechanics. This approach may facilitate accelerated rehabilitation and return to sport.