Biotenodesis screw for fixation of FDL transfer in the treatment of adult acquired flatfoot deformity

Dane K. Wukich, Bora Rhim, Nicholas James Lowery, Dekarlos Dial

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: In stage II PTTD, flexor digitorum longus (FDL) tendon transfer with an adjunctive bony procedure is the most common method of surgical correction. This paper presents an alternative method of fixation with a biotenodesis interference screw (Arthrex Biotenodesis Screw System) that allows proper tensioning of the FDL tendon transfer. Materials and Methods: We retrospectively reviewed 25 consecutive patients who underwent FDL tendon transfer utilizing a biotenodesis interference screw. Intraoperative stability was noted and any loss of correction was assessed postoperatively. Results: Stable fixation was achieved in 24 of the 25 patients who underwent FDL tendon transfer for PTTD. We were not able to achieve stable fixation in one patient due to improper placement of the bone tunnel. This was recognized intraoperatively and did not affect the final outcome. Conclusion: This method is technically easier to perform than the recommended technique by the manufacturer. It can be performed through a slightly smaller incision without disrupting the normal interconnections between flexor hallucis long (FHL) and FDL tendon at the Knot of Henry.

Original languageEnglish (US)
Pages (from-to)730-734
Number of pages5
JournalFoot and Ankle International
Issue number7
StatePublished - Jul 1 2008


  • Adult acquired flatfoot
  • Flexor digitorum longus
  • Posterior tibial tendon dysfunction
  • Tendon transfer

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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