Arbab, D., Frank, D., Bouillon, B. and Luring, C. (2017). Correction of flexible lesser toe deformity. Transfer of the flexor digitorum longus tendon. Oper. Orthopade Traumatol., 29 (5). S. 452 - 459. MUNICH: URBAN & VOGEL. ISSN 1439-0981

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Realignment and pain relief of toes 2-5 by flexor-to-extensor tendon transfer of the flexor digitorum longus (FDL) muscle. As an isolated procedure in flexible proximal interphalangeal (PIP) joint flexion and/or flexible metatarsophalangeal (MTP) joint extension (hammer toe). In combination with a metatarsal osteotomy or PIP joint arthrodesis in case of flexible MTP joint extension. General medical contraindications to surgical interventions. Stiffness of the PIP or MTP joint. Plantar stab incision in the distal interphalangeal (DIP) flexion crease and tenotomy of the FDL tendon. More proximally transverse incision on the plantar aspect of the proximal phalanx and isolation of the FDL tendon. The tendon is split longitudinally along the raphe and the two limbs are transferred from plantar to the dorsal aspect of the proximal phalanx adjacent to the bone. The crossed limbs are sutured to each other under appropriate tension and corrected position of the toe. Postoperative dressings for 3 weeks in corrected position. Subsequently tape dressing in plantar position for 6-12 weeks. Full weight bearing. A total of 24 toes with flexible PIP and/or MTP joint deformity were treated with a FDL tendon transfer. In 14 toes an isolated procedure was performed, in 10 cases an additional metatarsal osteotomy. Patients with operative treatment of the first ray, revision or reoperation were excluded. Mean follow-up was 8.4 (4-14) months. After 6 weeks 22 toes (92%) showed physiological alignment of the PIP and MTP joint. At the last follow-up, 4 (16%) toes had recurrent or persistent extension deformity of the MTP joint. There were no infections, overcorrections, impaired wound healing or transversal malalignment.

Item Type: Journal Article
CreatorsEmailORCIDORCID Put Code
URN: urn:nbn:de:hbz:38-216328
DOI: 10.1007/s00064-017-0511-y
Journal or Publication Title: Oper. Orthopade Traumatol.
Volume: 29
Number: 5
Page Range: S. 452 - 459
Date: 2017
Publisher: URBAN & VOGEL
Place of Publication: MUNICH
ISSN: 1439-0981
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
CLAWMultiple languages
OrthopedicsMultiple languages
Refereed: Yes


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