Becerro de Bengoa Vallejo Ricardo, Losa Iglesias Marta Elena, Rodriguez Miguel Fuentes, Tirado Fermín Viejo
Escuela Universitaria de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
J Am Podiatr Med Assoc. 2013 Sep-Oct;103(5):430-7. doi: 10.7547/1030430.
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.
趾长屈肌腱转位术已被广泛报道用于矫正柔性爪形趾和锤状趾畸形。最常见的技术使用两个皮肤切口，一个在足底，另一个在背侧。我们进行了一项尸体研究，以确定趾长屈肌腱是否可以通过一个独特的单一纵向中央背侧切口从其外侧或内侧转移到趾近节指骨的背侧。这种新方法的基本原理是将与双切口方法相关的趾血管受损风险降至最低。通过中央纵向背侧切口，在120个尸体足趾（第二和第三趾各60个）中尝试进行趾长屈肌腱转位。在100%的病例中，使用中央纵向背侧切口方法，趾长屈肌腱段足够长，能够成功地在第二和第三趾的趾短屈肌半腱之间转位，并在近端指间关节处进行切除关节成形术。将趾长屈肌腱转移到近节指骨背侧可用于矫正第二和第三趾的爪形趾和锤状趾畸形。仔细纵向切开屈肌腱鞘以暴露趾短屈肌腱及其纵向切口对于趾长屈肌腱在趾短屈肌半腱之间的成功转移至关重要。
