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SURGICAL ANATOMY FOR A NEW MINIMALLY INVASIVE APPROACH TO HARVEST THE FLEXOR DIGITORUM LONGUS TENDON: A CADAVER STUDY



Abstract

Introduction: The purpose of this cadaver study was to test feasibility and safety of a new technique for harvesting the FDL tendon through a plantar incision placed directly overlying the FDL division and to define the relevant surgical anatomy.

Materials and Methods: In eight cadaver feet the FDL tendon was exposed in the midfoot through a plantar incision. The FDL tendon was divided and pulled proximally through a wound in the hindfoot. All the tissues superficial to the FDL tendon were then reflected to check for any inadvertent damage to adjacent neurovascular structures.

Results: The FDL division lies midway between the back of the heel and the base of the second toe and about 3.7 cm medial to the lateral border of the foot. The medial and the lateral plantar neurovascular bundles are respectively about 0.43 cm and 0.86 cm away from the FDL division.

Conclusions: The FDL tendon can be harvested through a plantar incision. The adjacent neurovascular structures remained undamaged. Plantar surface anatomy guides placement of the plantar incision so that the incision can overlie directly over the FDL division.

Correspondence should be addressed to: D. Singh, BOFAS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.