Percutaneous flexor digitorum brevis tenotomy: An anatomical study

Foot Ankle Surg. 2022 Feb;28(2):176-180. doi: 10.1016/j.fas.2021.02.011. Epub 2021 Mar 2.

Abstract

Introduction: A percutaneous selective flexor digitorum brevis (FDB) tenotomy and a proximal interphalangeal (PIP) joint arthrolysis may correct a lesser claw toe deformity keeping flexor digitorum longus (FDL) and active flexion. Our study aimed to verify if the procedure was effective and reliable and if it respects the surrounding soft tissues.

Material and method: Twelve cadaveric lateral toes were used. A dissection ensured the integrity of both digital nerves, FDL and flexor pulleys and assessed the section of both FDB slips and PIP arthrolysis.

Results: A complete section of the two FDB slips was observed in 4 cases (33%). Arthrolysis was achieved in all cases. Surrounding soft tissues were found intact in all cases.

Conclusion: This procedure is effective regarding PIP arthrolysis, but a technical improvement is required to achieve a reliable section of both FDB slips. In the hands of an experienced surgeon, it has proven to be safe.

Keywords: Anatomy; Cadaveric; Claw toe; Elective tenotomy; Hammer; Lesser toe; Minimally invasive surgery; Percutaneous.

MeSH terms

  • Hammer Toe Syndrome* / surgery
  • Humans
  • Muscle, Skeletal / surgery
  • Tendon Transfer / methods
  • Tendons / surgery
  • Tenotomy* / methods