Flexor to Extensor Tendon Transfer: A New Method of Tensioning and Securing the Tendon

The Role of Toe Flexor-to-Extensor Transfer in Correcting Metatarsophalangeal Joint Instability of the Second Toe

“…We retrospectively reviewed 59 patients (64 feet) undergoing treatment for second MTPJ instability for which a modification of the FDL transfer was the primary procedure between 1996 and 2001. 2 Institutional Review Board approval and informed consent were obtained for this study. The patients' charts were reviewed for demographic information, severity and variety of symptoms, associated deformities, and procedures done for the second toe and associated additional procedures, such as hallux valgus correction and interdigital neuroma excision.…”

“…The ends of the split FDL tendon were held with hemostat clamp and looped superficial to the extensor tendon and extensor hood, creating a knot on the dorsal aspect of the toe. 2 To produce ideal tension on the transferred tendon for optimal correction and to prevent over-tightness of the MTPJ, the knot was pulled under tension with the MTPJ in approximately 30 degrees of dorsiflexion and the ankle in neutral dorsiflexion. The tendon was secured with several sutures both to itself and to the extensor hood.…”

Current Concept Review: Metatarsalgia

“…Originally described for the treatment of a flexible clawtoe deformity, transfer of the flexor digitorum longus tendon to the dorsum of proximal phalanx has become increasingly popular in order to treat painful instability of the second MTP joint. 8,17,44…”

Technique Tip: Modified Extensor Digitorum Brevis Tendon Transfer for Crossover Second Toe Correction

“…This technique has the advantage of better control of transverse plane motion and a decrease of potential stiffness associated with the flexorto-extensor tendon transfer technique. 1,2,4 However, it has a higher risk of recurrence of deformity because of inadequate suture technique. 3 Moreover, supination of the second toe may result from the pull of the extensor digitorum brevis.…”