Percutaneous Flexor Tenotomy-Office Procedure for Diabetic Toe Ulcerations

Lesser toe deformities include, but are not limited to, hammertoes, mallet toes, and claw toes. In people with diabetes, these conditions can create pressure points and lead to callous and ulcer formation. Conservative treatment methods such as extra-depth toe box shoes, pads, inserts, and splints provide mixed results with inevitable recurrent ulcerations. Closed or percutaneous flexor tenotomy is a definitive corrective procedure for severe lesser toe deformities often complicated by ulceration in the insensate patient with diabetes. The authors illustrate this simple, office-based procedure in a step-by-step approach to correct these deformities and thereby offload pressures. The technique provides rapid healing and may prevent potential toe and lower extremity amputations.