Journal of Foot and Ankle Surgery
Volume 48, Issue 3 , Pages 398-401, May 2009

Flexor Hallucis Longus and Extensor Digitorum Longus Tendon Transfers for Balancing the Foot Following Transmetatarsal Amputation

  • Thomas S. Roukis, DPM, PhD, FACFAS

      Affiliations

    • Chief, Limb Preservation Service, Vascular/Endovascular Surgery Service, Department of Surgery, Director, Limb Preservation Complex Lower Extremity Surgery and Research Fellowship, Madigan Army Medical Center, Tacoma, WA
    • Corresponding Author InformationAddress correspondence to: Thomas S. Roukis, DPM, PhD, FACFAS, Chief, Limb Preservation Service, Vascular/Endovascular Surgery Service, Department of Surgery, Director Limb Preservation Complex Lower Extremity Surgery and Research Fellowship, Madigan Army Medical Center, 9040-A Fitzsimmons Avenue, MCHJ-SV, Tacoma, WA 98431.

published online 23 March 2009.

Transmetatarsal amputation is a useful surgical procedure that is applicable to the treatment of the dysvascular, neuropathic, and/or traumatized forefoot. Because of the loss of the insertions of some of the extrinsic pedal musculature, transmetatarsal amputation is known to be associated with imbalance of the residual foot, and this can lead to complications related to cutaneous compromise, as well as difficulties with bracing and shoe fit. In this techniques report, we describe a combination of tendon transfers that use flexor hallucis longus and extensor digitorum longus, which can be useful in preventing pedal imbalance following transmetatarsal amputation.

Key Words: dysvascular foot, imbalance, Nitinol, tendon anchor, ulceration

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 “Tips, Quips, and Pearls” is a special section in The Journal of Foot & Ankle Surgery which is devoted to the sharing of ideas to make the practice of foot and ankle surgery easier. We invite our readers to share ideas with us in the form of special tips regarding diagnostic or surgical procedures, new devices or modifications of devices for making a surgical procedure a little bit easier, or virtually any other “pearl” that the reader believes will assist the foot and ankle surgeon in providing better care. Please address your tips to: D. Scot Malay, DPM, MSCE, FACFAS, Editor, The Journal of Foot & Ankle Surgery, PO Box 590595, San Francisco, CA 94159-0595; E-mail: editorjfas@gmail.com

 Financial Disclosure: None reported.

 Conflict of Interest: None reported.

 Disclaimer: The opinions and assertions contained herein are the private view of the author and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.

PII: S1067-2516(08)00534-6

doi:10.1053/j.jfas.2008.12.013

Journal of Foot and Ankle Surgery
Volume 48, Issue 3 , Pages 398-401, May 2009

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