Intramedular transfer of the flexor digitorum brevis tendon for the correction of clawtoe/hammertoe deformity: A cross-sectional study

Ann Anat. 2021 Mar:234:151646. doi: 10.1016/j.aanat.2020.151646. Epub 2020 Nov 25.

Abstract

Background: A literature review did not reveal any studies concerning the intramedullary transfer of the flexor digitorum brevis tendons (FDB) technique with a single longitudinal incision through the proximal phalanx of the toes. The main goal of this investigation was to demonstrate whether the FDB tendons of the toes are long enough to enable intramedullary transfer to the dorsal area of the proximal phalanx.

Methods: We examined whether the technique would allow the surgeon to transfer the FDB tendons through the proximal phalanx of the toes. The technique transfers the FDB tendons through the proximal phalanx dorsal area of the toes using an intramedullary transfer of the FDB tendons. The intramedullary transfer of the FDB tendons was performed through a single dorsal incision.

Results: The FDB tendons for the second, third, and fourth toes were performed in 100% of the feet. No ruptures in any toe in which the surgical technique was performed was noted, and no proximal phalanges of the second, third, and fourth toes were fractured.

Conclusions: Transfer of FDB tendons via the intramedullary approach of the proximal phalanx of the second, third, and fourth toes is possible. The FDB tendons have sufficient length for transfer via an intramedullary transfer and were carried out in 100% of the second toes. For a successful transfer, it is essential to perform a thorough resection of the extensor digitorum longus aponeurosis since it has expansions intimately attached to the plantar base of the proximal phalanx of the toe.

Keywords: Clawtoe; Hammertoe; Interphalangeal joint of foot; Tendon transfer; Toe joints.

MeSH terms

  • Cross-Sectional Studies
  • Hammer Toe Syndrome* / surgery
  • Humans
  • Tendon Transfer
  • Tendons / surgery
  • Toes