Absence of the flexor digitorum longus tendon: an MRI study

Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
Merzesh MagraMark B Davies

Abstract

Flexor digitorum longus (FDL) is the primary flexor of the lateral four toes. It is a reliable source of tendon for transfer surgery. We present a case whereby a patient who required a reconstruction for adult acquired flatfoot deformity using FDL as a dynamic structure for transfer was found to have an absent FDL tendon at the time of operation, necessitating the use of flexor hallucis longus (FHL) instead. This unusual finding prompted us to investigate the frequency of absence of the FDL tendon. We reviewed our hospital MRI database of foot and ankle images specifically looking for patients with absence of this tendon. After randomization, 756 images were reviewed independently by two surgeons and a consultant musculoskeletal radiologist. No instances of an absent FDL tendon were identified. In conclusion, the frequency of absence of the FDL tendon is less than 1 in 750. Surgeons who require FDL for tendon transfer surgery need not image the foot preoperatively to anticipate the need for the use of FHL as an alternative.

References

Jul 18, 2006·Foot & Ankle International·Bernard G LaRue, Eric P Anctil
Feb 16, 2008·Foot & Ankle International·Vinod Kumar PanchbhaviSantaram Vallurupalli
Mar 24, 2010·The Foot·Thomas W Barwick, Paul J Mackenney
May 21, 2010·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Michael J OddyMark B Davies

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