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Flexor digitorum longus tendon transfer, lengthening osteotomy successful in treatment of flatfoot

Issue: July 2012

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SAN DIEGO – Researchers found that lengthening osteotomies of the calcaneus and flexor digitorum longus tendon transfer adequately corrected adult acquired flatfoot deformity, according to a study presented at the American Orthopaedic Foot and Ankle Society Annual Meeting here.

“Soft tissue treatment alone cannot correct bony deformity,” study presenter Martinus Richter, MD, PhD, said.

Martinus Richter

Richter and his colleagues examined the amount of correction for and clinical outcomes of flexor digitorum longus tendon transfer and lengthening osteotomy of the calcaneus as a treatment for adult acquired flatfoot deformity (AFDD).

The researchers conducted a prospective, clinical follow-up study of 102 patients (42% male, with a mean age of 58.2 years) and 112 feet. Patients underwent flexor digitorum longus tendon transfer and lengthening osteotomy of the calcaneus for AFDD between September 1, 2006 and August 31, 2009.

According to Richter, the researchers conducted patient examinations preoperatively and at the 2-year follow-up. Outcome measures included stages of posterior tibialis insufficiency, first talometatarsal (TMT) index, pedographic midfoot contact area, force percentage and Visual Analog Scale (VAS) of the foot and ankle.

The investigators found all patients improved in all parameters at the 2-year follow-up. The TMT index normalized, posterior tibialis insufficiency and pedography improved and pedography normalized, Richter said. At 7 weeks, the patients achieved 100% weightbearing. He and his colleagues noted few complications with the procedure.

“This method allows safe and reliable correction of adult acquired flatfoot deformity,” Richter said.

Reference:

• Richter M, Zech S. Lengthening osteotomy of the calcaneus and flexor digitorum longus tendon transfer in adult acquired flatfoot deformity improves talo-1st metatarsal-index. Presented at the American Orthopaedic Foot and Ankle Society 2012 Annual Meeting. San Diego.
• Disclosure: Richter receives royalties and research support from SBI and Intercus, is a paid consultant for SBI and owns stock options in SBI.