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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8696481/ http://dx.doi.org/10.1177/2473011419S00122 |
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author | Bull, Patrick Goss, David Halverson, Adam |
author_facet | Bull, Patrick Goss, David Halverson, Adam |
author_sort | Bull, Patrick |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-8696481 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-86964812022-01-28 Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study Bull, Patrick Goss, David Halverson, Adam Foot Ankle Orthop Article 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. SAGE Publications 2019-10-28 /pmc/articles/PMC8696481/ http://dx.doi.org/10.1177/2473011419S00122 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Bull, Patrick Goss, David Halverson, Adam Minimally Invasive Retrograde Method of Harvesting the Flexor Hallucis Longus Tendon: A Cadaveric Study |
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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8696481/ http://dx.doi.org/10.1177/2473011419S00122 |
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