Better than transfer? Tibialis Anterior Tendon Lengthening: Treatment of Plantar Lateral Column Diabetic Foot Ulcers

Tendon transfer anchor
Anchoring anterior tibial tendon laterally to modify supinatory/pronatory moment. Salvaging foot in previously ambulatory patient with severe grangrene. SALSA, 2013

 

Removal of gangrenous sole and forefoot
Removal of gangrenous sole and forefoot. SALSA, 2013
Thick skin graft plantar laterally. SALSA 2013

 

 

 

 

 

 

 

 

 

 

We frequently perform tendon transfers (above) for severe deformities to allow for spreading force out over a larger unit area and over time. This recent suggestion (below) got us thinking, however.

 

Tibialis Anterior Tendon Lengthening: Adjunctive Treatment of Plantar Lateral Column Diabetic Foot Ulcers.

This clever work from Kim and coworkers from our East Coast toemigos shows a potential clever alternative to tendon transfer in people with plantar lateral wounds. While we tend to prefer tendon transfer (below) to lengthening or tenotomy for severe deformity, we believe that lengthening may be a great adjunct for less severe contractures/deformity.

 

 

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