Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study
Category: Ankle Introduction/Purpose: Utilization of the flexor hallucis longus (FHL) tendon is well described for several tendon augmentation procedures. Recently, several authors have described a minimally invasive (MI) technique to harvest the tendon utilizing a hamstring tendon stripper. The pur...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-10-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011419S00122 |
| _version_ | 1818511178399219712 |
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| author | Patrick Bull DO David Goss DO Adam Halverson DO |
| author_facet | Patrick Bull DO David Goss DO Adam Halverson DO |
| author_sort | Patrick Bull DO |
| collection | DOAJ |
| description | Category: Ankle Introduction/Purpose: Utilization of the flexor hallucis longus (FHL) tendon is well described for several tendon augmentation procedures. Recently, several authors have described a minimally invasive (MI) technique to harvest the tendon utilizing a hamstring tendon stripper. The purpose of this study was to evaluate the safety and effectiveness of harvesting the FHL tendon utilizing this novel technique. Methods: The FHL tendon was harvested through a transverse plantar incision over the interphalangeal joint of the great toe in 10 fresh-frozen cadaver lower extremities. Complications, tendon length and interconnections between the FHL and flexor digitorum longus (FDL) were recorded. The specimens were then dissected by a single surgeon in a standardized fashion and damage to any surrounding structures was recorded. Results: The average length of the FHL tendon from the distal stump to the 1st inter-tendinous connection was 13.33 cm (range 8.8-16 cm, SD: 2.28 cm). Eight cadavers demonstrated Plaass Type 1 interconnections while 2 were Type 3. There was no injury to the medial and lateral plantar arteries or nerves, plantar plate or FDL tendons. One FHL tendon was amputated during graft harvesting. Conclusion: Care must be taken when approaching the sustentaculum with the tendon harvester in order to avoid amputation of the graft against a hard bony endpoint. Additionally, flexion and extension of the lateral toes can aid in successful tendon harvest when tendon interconnections are encountered. Utilizing this MI technique appears to be a safe and effective way to obtain a long FHL tendon graft tissue augmentation. |
| first_indexed | 2024-12-10T23:29:54Z |
| format | Article |
| id | doaj.art-93c60f90cc2b489b9733a655ba9b4368 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-10T23:29:54Z |
| publishDate | 2019-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-93c60f90cc2b489b9733a655ba9b43682022-12-22T01:29:25ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142019-10-01410.1177/2473011419S00122Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric StudyPatrick Bull DODavid Goss DOAdam Halverson DOCategory: Ankle Introduction/Purpose: Utilization of the flexor hallucis longus (FHL) tendon is well described for several tendon augmentation procedures. Recently, several authors have described a minimally invasive (MI) technique to harvest the tendon utilizing a hamstring tendon stripper. The purpose of this study was to evaluate the safety and effectiveness of harvesting the FHL tendon utilizing this novel technique. Methods: The FHL tendon was harvested through a transverse plantar incision over the interphalangeal joint of the great toe in 10 fresh-frozen cadaver lower extremities. Complications, tendon length and interconnections between the FHL and flexor digitorum longus (FDL) were recorded. The specimens were then dissected by a single surgeon in a standardized fashion and damage to any surrounding structures was recorded. Results: The average length of the FHL tendon from the distal stump to the 1st inter-tendinous connection was 13.33 cm (range 8.8-16 cm, SD: 2.28 cm). Eight cadavers demonstrated Plaass Type 1 interconnections while 2 were Type 3. There was no injury to the medial and lateral plantar arteries or nerves, plantar plate or FDL tendons. One FHL tendon was amputated during graft harvesting. Conclusion: Care must be taken when approaching the sustentaculum with the tendon harvester in order to avoid amputation of the graft against a hard bony endpoint. Additionally, flexion and extension of the lateral toes can aid in successful tendon harvest when tendon interconnections are encountered. Utilizing this MI technique appears to be a safe and effective way to obtain a long FHL tendon graft tissue augmentation.https://doi.org/10.1177/2473011419S00122 |
| spellingShingle | Patrick Bull DO David Goss DO Adam Halverson DO Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study Foot & Ankle Orthopaedics |
| title | Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study |
| title_full | Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study |
| title_fullStr | Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study |
| title_full_unstemmed | Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study |
| title_short | Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study |
| title_sort | minimally invasive retrograde method of harvesting the flexor hallucis longus tendon a cadaveric study |
| url | https://doi.org/10.1177/2473011419S00122 |
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