Percutaneous long flexor needle tenotomy of toes: a simple, safe, and effective procedure for diabetic foot salvage and intertrigo. Single-centre retrospective cohort study

IF 1.4 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery Pub Date : 2026-09-01 Epub Date: 2026-05-20 DOI:10.1053/j.jfas.2026.05.011

Rajendran Purushothaman Dr. MBBS, MS, DNB (GEN.SURGERY), MRCS(EDIN), M.Ch, DNB (PLASTIC SUR) (AURA PLASTIC SURGERY), Prasanna Kumar Gupta Dr. MBBS, MD, R. Vikram Kumar Dr. MBBS, MS, M.Ch

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引用次数: 0

Abstract

Background

Diabetes causes toe deformities leading to trophic ulcers, intertrigo, and amputations.

Purpose

Percutaneous long flexor tenotomy rapidly heals flexible claw toe ulcers with low recurrence, outperforming conservative offloading and strongly recommended by International Working Group for Diabetic Foot (IWGDF) guidelines.

Methods and study design

This retrospective cohort study analysed single author cases from February 2019 to April 2026, evaluated percutaneous long flexor tenotomy effectiveness in resolving diabetic toe pathologies including ulcer healing, callosity prevention, fungal lesion clearance, resolution timelines, and rates of recurrence and complications.

Results

Of 49 percutaneous long flexor tenotomies in 25 patients for intertrigo and trophic toe changes across all toes, mean follow-up was 16.93 months, with healing times of 38.5 days for intertrigo and 27.4 days for trophic changes; no serious complications occurred, recurrences were minimal and manageable yielding 4.08 percent failure, and 9 transfer lesions resolved after secondary procedures.

Conclusion

Our cohort demonstrated high healing rates for intertrigo and trophic toe changes, with low failure rates, manageable recurrences and transfer lesions, and minimal complications affirming broad safety and efficacy of the procedure. This procedural efficacy is particularly significant given the high rates of diabetic foot complications, where even minor toe deformities can precipitate severe ulceration and subsequent limb loss.

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经皮长屈指针断趾：一种简单、安全、有效的治疗糖尿病足的方法。单中心回顾性队列研究。

背景：糖尿病引起脚趾畸形，导致营养性溃疡、三趾间沟和截肢。目的：经皮长屈肌腱切开术快速愈合低复发率的挠性爪趾溃疡，优于保守减压，并被国际糖尿病足工作组（IWGDF）指南强烈推荐。方法和研究设计：本回顾性队列研究分析了2019年2月至2026年4月的单作者病例，评估经皮长屈肌腱切开术治疗糖尿病脚趾病变的有效性，包括溃疡愈合、预防老茧、真菌病变清除、消退时间、复发率和并发症。结果：经皮49例长屈肌腱切断术25例，所有趾间及营养性趾改变患者，平均随访16.93个月，其中三间及营养性趾改变患者愈合时间38.5天，营养性趾改变患者愈合时间27.4天；无严重并发症发生，复发率极低且可控，失败率为4.08%，9个转移病灶在二次手术后消退。结论：我们的队列研究表明，三趾间和营养趾病变的治愈率高，失败率低，复发和转移性病变可控，并发症最小，证实了该手术的安全性和有效性。考虑到糖尿病足并发症的高发率，这种手术效果尤其显著，即使是轻微的脚趾畸形也可能导致严重的溃疡和随后的肢体丧失。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY

CiteScore

2.30

自引率

7.70%

发文量

234

审稿时长

29.8 weeks

期刊介绍： The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.