Tendon and Soft tissue procedures

Question 1

Tenosynovectomy of PTT

Answer 1

Debridement of PTT when no tendon rupture/tear present

Question 2

What makes up the Spring ligament complex

Answer 2

• superomedial portion
• plantar medial oblique ligaments
• Plantar inferior portion

Question 3

Spring ligament reconstruction, reefing, desmoplasty technique

Answer 3

Pants over vest imbrication with tightening of the spring ligament

Question 4

Why is FDL used as a tendon transfer with PTTD

Answer 4

because it is in direct opposition to PB, expendable, and proximity to PTT

Question 5

What technique is used to transfer FDL tendon

Answer 5

FDL cut just proximal to Knot of Henry and tenodesed to PTT

Question 6

Describe the Kidner procedure

Answer 6

• Used to relieve an enlarged navicular cuneiform

- Remove accessory navicular until flush with medial cuneiform. Reroute the PTT distal plantar through navicular

Question 7

Describe the Cobb procedure

Answer 7

-TA split proximally and rerouted through medial cuneiform. Tenodesed to PTT

Question 8

What is the major negative of the Cobb procedure

Answer 8

sacrifices major inverter/adductor of the foot

Question 9

Frequency of Tendo Achilles lengthening/ gastroc recession

-Why is it done

Answer 9

Most common soft tissue procedure performed in flatfoot reconstruction

-Restores Calcaneal inclination angle

Question 10

Describe the Young tenosuspension

Answer 10

-Reroute TA through Keyhole in the Navicular with insertion still intact

Question 11

Describe Steindler stripping procedure

Answer 11

-Sectioning of plantar fascia, 1st layer of plantar muscles, long plantar ligament

Question 12

What is one of the major side effects of Steindler stripping

Answer 12

can active Charcot

Question 13

Describe subcutaneous fasciotomy

Answer 13

cut plantar fascia at insertion

Question 14

Describe plantar medial release

Answer 14

-release plantar musculature and ligements at plantar medial foot

Question 15

Describe Hibbs tenosuspension

Answer 15

-EDL stlips combined and transferred to lateral cuneiform

Question 16

Describe Jones tenosuspension procedure

Answer 16

transfer of EHL to 1st MT head

Question 17

Describe the Heyman tenosuspension procedure

Answer 17

transfer EDL to met necks

Question 18

Describe the Tibialis Anterior tendon transfer procedure

Answer 18

TA rerouted to lateral cuneiform

-decreases the supinatory forces and increases pronation

Question 19

What is the Technique with Tibialis Anterior tendon transfer

Answer 19

3 incisions:

• –release from insertion
• –Anterior leg to retrieve tendon
• –over lateral cuneiform for re-insertion

Question 20

Describe the Posterior tibial tendon transfer

Answer 20

-PTT through interosseus membrane to the 3rd cuneiform or transferred to TA

Question 21

What is one of the major cons with Posterior tibial tendon transfer procedure

Answer 21

-PT taken out of phase

Question 22

Describe the split tibialis anterior tendon transfer procedure

Answer 22

1/2 tibialis anterior tendon is transferred to cuboid or peroneus tertius

Question 23

Describe the Murphy procedure

Answer 23

Achilles insertion to dorsal calcaneus just posterior to STJ

Question 24

Describe peroneus longus tendon transfer

Answer 24

peroneus longus tendon inserted into base of 3rd metatarsal

Question 25

Peroneal stop procedure

Answer 25

Peroneus Longus tenodesis to Peroneus brevis

-decreases PF deforming force of 1st MT, increases eversion

Question 26

Describe FHL transfer procedure

Answer 26

tranfer from the distal phalanx to the base of the proximal phalanx