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The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
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Percutaneous flexor digitorum brevis tenotomy: An anatomical study.

Paulo Carvalho1, Miki Dalmau-Pastor2, Caroline Lozi3

  • 1Hospital da Ordem Terceira Chiado, Lisbon, Portugal; MIFAS by GRECMIP (Minimally Invasive Foot and Ankle Society), Merignac, France.

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|March 8, 2021
PubMed
Summary

Percutaneous flexor digitorum brevis (FDB) tenotomy and proximal interphalangeal (PIP) joint arthrolysis effectively address lesser claw toe deformities. While safe for surrounding tissues, technical improvements are needed for consistent FDB tenotomy.

Keywords:
AnatomyCadavericClaw toeElective tenotomyHammerLesser toeMinimally invasive surgeryPercutaneous

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Area of Science:

  • Orthopedic surgery
  • Foot and ankle reconstruction
  • Surgical technique evaluation

Background:

  • Lesser claw toe deformity can be corrected by percutaneous flexor digitorum brevis (FDB) tenotomy and proximal interphalangeal (PIP) joint arthrolysis.
  • This procedure aims to preserve flexor digitorum longus (FDL) function and active flexion.

Purpose of the Study:

  • To evaluate the effectiveness and reliability of a percutaneous selective FDB tenotomy combined with PIP joint arthrolysis.
  • To assess the procedure's safety concerning surrounding soft tissues.

Main Methods:

  • Twelve cadaveric lateral toes were utilized for the study.
  • Dissection was performed to ensure digital nerve and flexor tendon integrity.
  • Assessment included FDB slip section and PIP joint arthrolysis achievement.

Main Results:

  • Proximal interphalangeal (PIP) joint arthrolysis was successful in all cases.
  • Complete section of both flexor digitorum brevis (FDB) slips occurred in 33% of specimens.
  • Surrounding soft tissues remained intact throughout the procedure.

Conclusions:

  • The combined procedure is effective for PIP joint arthrolysis in lesser claw toe correction.
  • Technical modifications are necessary to ensure consistent FDB tenotomy.
  • The technique is safe when performed by experienced surgeons.