Tendon Transfer for Hammertoe (FDL tendon transfer)

Overview

This procedure is used to reroute a tendon from beneath a flexible hammertoe to a new path along the top of the toe. Instead of pulling the toe into a bend, the tendon becomes a corrective force that helps straighten the toe.

Preparation

After anesthesia is administered, the patient is positioned and the foot is cleansed and sterilized. The surgeon makes two incisions on the bottom of the toe to access and release the FDL tendon (one of the two tendons that runs beneath the toe). A third incision is made along the top of the toe.

Detaching the Tendon

The surgeon reaches beneath the bones of the toe and detaches the flexor digitorum longus tendon. This alleviates the constant pulling force that has been drawing the toe into its bent shape, allowing the toe to relax.

Rerouting the Tendon

The tendon is divided into two strands. The strands are pulled up along either side of the toe and the ends are brought together on the top of the bone. The surgeon uses sutures to reconnect the ends of the tendon and anchor it in place. The tendon will now provide a downward force to prevent the toe from curling.

End of Procedure and Aftercare

The incision is closed and bandaged. Most patients can walk after surgery without the aid of a crutch or walker. Typically, patients wear a bandage or splint for two to four weeks after surgery. Recovery usually takes about eight weeks.

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