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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 6, 801-802.
doi: 10.1302/0301-620X.90B6.19727  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Is there a role for lengthening flexor hallucis and flexor digitorum longus tendons in surgery for club foot?

A PRELIMINARY REPORT

O. Lahoti, FRCS(Orth), FRCS(C), Consultant Orthopaedic Surgeon1; and S. Bajaj, MS(Orth), FRCS, Specialist Registrar2

1 Orthopaedic Department King’s College Hospital, Denmark Hill, London SE5 9RS, UK.
2 Orthopaedic Department, University Hospital, Lewisham, London SE13 6LH, UK.

Correspondence should be sent to Mr O. Lahoti; e-mail: omlahoti{at}mac.com

Most cases of club foot (congenital talipes equinovarus) respond to non-operative treatment but resistant cases may need surgery. It is broadly accepted that lengthening of tendo Achillis, the tendon of tibialis posterior and capsulotomy of the ankle and subtalar joints are necessary during surgical release, but there is no consensus as to whether lengthening of the tendons of flexor hallucis longus and flexor digitorum longus is required.

We randomised 13 children with severe bilateral club foot deformities to undergo lengthening of the flexor hallucis longus and flexor digitorum longus tendons on one side and simple decompression on the other. We found no difference in the deformities of the toes between the lengthened and non-lengthened sides at a mean follow-up of four years (2 to 6).

We conclude that routine lengthening of the tendons of flexor hallucis longus and flexor digitorum longus during soft-tissue surgery for resistant club foot is not necessary.




eLetters:

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Step by step surgical treatment of club foot deformity - probably the best treatment !
Zoran S Vukasinovic, et al.
J Bone Joint Surg Br Online, 19 Jun 2008 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General