Poster - #VH-74578 - Keywords: Rearfoot and Ankle Reconstruction Tendon Transfer

Flexor Digitorum Longus to Peroneal Tendon Transfers - A Mini Case Study and Technique Guide

Shalvi Prasad DPM [1], Anish Sharma DPM [1], Ian Burtenshaw, DPM, FACFAS [2], Chad Seidenstricker, DPM, FACFAS [2]
[1] DVA – New Mexico Veterans Affairs Health Care System &Kaiser Foundation Hospital [2] New Mexico Orthopaedics

ABSTRACT:
The transfer of flexor digitorum longus (FDL) to peroneal tendons is a rare and novel procedure, not well-known in foot and ankle surgery. In patients with significant ankle pain and instability, this tendon transfer can allow patients to have a decrease in pain and regain stability while ambulating. Current treatment includes bracing, physical therapy and reconstruction of lateral ankle ligaments with rearfoot osteotomies. Understanding the surgical technique and varying clinical presentations is pivotal for effective management and enhanced patient outcomes. This case series highlights cases of FDL tendon transfers to peroneal tendons with at least 1 year of follow up. In our study, 2 patients experienced substantial pain relief and restored ankle stability after undergoing FDL-to-peroneal tendon transfers. This technique aligns with results reported in literature. Sherman (2019) demonstrated similar outcomes, showing improved functional stability following transfers in patients with peroneal tendinopathy. Seybold (2016) reported successful outcomes in patients with peroneal tendon tears treated with lateral transfer of FDL or flexor hallucis longus, noting reduced pain and improved ankle function. Borton (1998) documented favorable results in cases of transverse rupture of peroneal tendons, with FDL transfers achieving pain reduction and functional recovery. Both patients had partial or complete rupture of both peroneal tendons and, 1 year postoperatively, reported no pain and increased eversion strength. Our findings support current research, emphasizing the importance of ensuring 5/5 muscle strength in the FDL prior to surgery. This novel approach provides a viable surgical option for patients who have exhausted conservative measures.