Proximal Phalanx and Flexor Digitorum Longus Tendon Biomechanics in Flexor to Extensor Tendon Transfer

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw or hammer toe deformities. In contrast, a search of the literature revealed no previous reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions. We performed a cadaver study to determine whether the flexor digitorum brevis tendon is long enough to be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect. Methods: Transposition of the flexor digitorum brevis tendon was attempted in 180 toes of cadaver feet: 45 second toes, 45 third toes, 45 fourth toes, and 45 fifth toes. Results: The flexor digitorum brevis tendon was long enough to be successfully transposed in 100% of the second, third, and fourth toes and in 42 (93.3%) of the fifth toes. In the three remaining fifth toes (6.7%), the flexor digitorum brevis tendon was absent, a known anatomical variation. Conclusions: Transfer of the flexor digitorum brevis tendon to the dorsum of the proximal phalanx can be performed for correction of claw or hammer toe deformities, especially in the second, third, and fourth toes. The transverse aponeurotic fibers originating from the extensor digitorum longus impede the transfer of the flexor digitorum brevis tendon, and meticulous excision of these fibers is essential to the success of the procedure. (J Am Podiatr Med Assoc 98(1): 27–35, 2008)

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Passive engineering mechanism enhancement of a flexor digitorum longus tendon transfer procedure

Journal of Orthopaedic Research® ◽

10.1002/jor.24051 ◽

2018 ◽

Vol 36 (11) ◽

pp. 3033-3042 ◽

Cited By ~ 1

Author(s):

Connor M. Pihl ◽

Christina J. Stender ◽

Ravi Balasubramanian ◽

Kylie M. Edinger ◽

Bruce J. Sangeorzan ◽

...

Keyword(s):

Tendon Transfer ◽

Flexor Digitorum Longus ◽

Longus Tendon ◽

Flexor Digitorum

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Single Longitudinal Dorsal Incision Approach to Transfer the Flexor Digitorum Longus Tendon Between the Flexor Digitorum Brevis Hemitendons

Journal of the American Podiatric Medical Association ◽

10.7547/1030430 ◽

2013 ◽

Vol 103 (5) ◽

pp. 430-437 ◽

Cited By ~ 1

Author(s):

Ricardo Becerro de Bengoa Vallejo ◽

Marta Elena Losa Iglesias ◽

Miguel Fuentes Rodriguez ◽

Fermín Viejo Tirado

Keyword(s):

Proximal Phalanx ◽

Tendon Sheath ◽

Proximal Interphalangeal Joint ◽

Flexor Digitorum Longus ◽

Longus Tendon ◽

Longitudinal Incision ◽

Novel Approach ◽

Vascular Compromise ◽

Flexor Digitorum Brevis ◽

Flexor Digitorum

Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw and hammertoe deformities. The most common technique uses two cutaneous incisions, one plantar and another dorsal. We performed a cadaveric study to determine whether the flexor digitorum longus tendon could be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect through a unique single longitudinal central dorsal incision. The rationale for this novel approach was to minimize the risk of vascular compromise to the digit associated with the two-incision approach. Transposition of the flexor digitorum longus tendon was attempted in 120 toes of cadaveric feet (60 each second and third digits) through a central longitudinal dorsal incision. The flexor digitorum longus tendon segment was long enough to be successfully transposed between the flexor digitorum brevis hemitendons of the second and third toes in 100% of the cases using the central longitudinal dorsal incision approach, with a resection arthroplasty at the proximal interphalangeal joint. Transfer of the flexor digitorum longus tendon to the dorsum of the proximal phalanx can be performed for the correction of claw and hammertoe deformities in the second and third digits. The meticulous longitudinal incision of the flexor tendon sheath to expose the flexor digitorum brevis tendon and its longitudinal incision are essential to the successful transfer of the flexor digitorum longus tendon between the flexor digitorum brevis hemitendons. (J Am Podiatr Med Assoc 103(5): 430–437, 2013)

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