• 1

    Sarrafian SE, Topouzian LK: Anatomy and physiology of the extensor apparatus of the toes. .J Bone Joint Surg Am 51::669. ,1969. .

  • 2

    Sandeman JC: The role of soft tissue correction of claw toes. .Br J Clin Pract 21::489. ,1967. .

  • 3

    Coughlin MJ, Mann RA: “Lesser Toe Deformities,” in Surgery of the Foot and Ankle, 7th Ed, ed by MJ Coughlin, RA Mann, p 328, Mosby, St. Louis. ,1999. .

  • 4

    Richardson EG: “Lesser Toe Abnormalities,” in Campbell’s Operative Orthopaedics, 8th Ed, ed by AH Crenshaw, p 99, Mosby–Year Book, St. Louis. ,1992. .

  • 5

    Scheck M: Etiology of acquired hammertoe deformity. .Clin Orthop 123::63. ,1977. .

  • 6

    Engle ET, Morton DJ: Notes on foot disorders among natives of the Belgian Congo. .J Bone Joint Surg 13::311. ,1931. .

  • 7

    Lutter LD: “Toe Deformities,” in Atlas of Adult Foot and Ankle Surgery, p 74, Mosby–Year Book, St. Louis. ,1997. .

  • 8

    Cyphers SM, Feiwell E: Review of the Girdlestone-Taylor procedure for clawtoes in myelodysplasia. .Foot Ankle 8::229. ,1988. .

  • 9

    Barbari SA, Brevig K: Correction of clawtoes by the Girdlestone-Taylor flexor to extensor transfer procedure. .Foot Ankle 5::67. ,1984. .

  • 10

    Newman RJ, Fitton JM: An evaluation of operative procedures in the treatment of hammertoe. .Acta Orthop Scand 50::709. ,1979. .

  • 11

    Parrish TF: Dynamic correction of clawtoes. .Orthop Clin North Am 4::97. ,1973. .

  • 12

    Pyper JB: The flexor-extensor transplant operation for claw toes. .J Bone Joint Surg Br 40::528. ,1958. .

  • 13

    Taylor RG: The treatment of claw toes by multiple transfers of flexor into extensor tendons. .J Bone Joint Surg Br 33::539. ,1951. .

  • 14

    Sarrafian SK: Anatomy of the Foot and Ankle, JB Lippincott, Philadelphia. ,1983. , p 243.

  • 15

    LeDouble AF: Traité des variations du systéme musculaire del l’homme et de leur signification au point de vue de l’anthropologie et zoologique, Vol 2, Schleicher Fréres, Paris. ,1897. , pp 327–60, 374–97, 402–8, 413–21, 425–27.

  • 16

    Nathan H, Gloobe H: Flexor digitorum brevis: anatomical variations. .Anat Anz 135::295. ,1974. .

  • 17

    Testut L: Les anomalies musculaires chez l’homme expliqueés par l’anatomie comparée: Leur importance en anthropologie, Masson, Paris. ,1884. , pp 588–694, 705–32, 735–37, 741–44.

  • 18

    Testut L: Les anomalies musculaires considérées du point de vue de la ligature des artéres, Doin, Paris. ,1892. , pp 38–40.

Transfer of the Flexor Digitorum Brevis Tendon

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  • 1 Department of Nursing, Escuela Universitaria de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
  • | 2 Department of Anatomy and Embryology, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
  • | 3 Department of Podiatry, Facultad de Ciencias de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
  • | 4 Department of Surgical Sciences, New York College of Podiatric Medicine, New York, NY.
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Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw or hammer toe deformities. In contrast, a search of the literature revealed no previous reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions. We performed a cadaver study to determine whether the flexor digitorum brevis tendon is long enough to be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect.

Methods: Transposition of the flexor digitorum brevis tendon was attempted in 180 toes of cadaver feet: 45 second toes, 45 third toes, 45 fourth toes, and 45 fifth toes.

Results: The flexor digitorum brevis tendon was long enough to be successfully transposed in 100% of the second, third, and fourth toes and in 42 (93.3%) of the fifth toes. In the three remaining fifth toes (6.7%), the flexor digitorum brevis tendon was absent, a known anatomical variation.

Conclusions: Transfer of the flexor digitorum brevis tendon to the dorsum of the proximal phalanx can be performed for correction of claw or hammer toe deformities, especially in the second, third, and fourth toes. The transverse aponeurotic fibers originating from the extensor digitorum longus impede the transfer of the flexor digitorum brevis tendon, and meticulous excision of these fibers is essential to the success of the procedure. (J Am Podiatr Med Assoc 98(1): 27–35, 2008)

Corresponding author: Ricardo Becerro de Bengoa Vallejo, DPM, PhD, Department of Nursing, Escuela Universitaria de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain. (E-mail: ribebeva@teleline.es)