The Journal of Bone and Joint Surgery, Vol 77, Issue 10 1557-1564, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Reconstruction with tenodesis in an adult flatfoot model. A biomechanical evaluation of four methods
DB Thordarson, H Schmotzer and J Chon
Department of Orthopaedic Surgery, University of Southern California, Los Angeles 90033, USA.
Six fresh-frozen adult cadaveric specimens were mounted in an Instron
materials testing machine with use of a cemented intramedullary rod.
Angular relationships between the first metatarsal and the talus were
recorded with a sonic digitizer. A flatfoot deformity was created by
dividing the talonavicular joint capsule (superiorly, medially, and
inferiorly), the spring ligament, the anteromedial aspect of the subtalar
joint capsule, and the plantar fascia. Angular displacement in the sagittal
and transverse planes was recorded at no load and at 100, 350, and
700-newton plantar loads. Each specimen was subjected to four different
reconstructions with tenodesis, and the angular relationship between the
first metatarsal and the talus was measured at the four levels of load. A
reconstruction with use of the peroneus longus tendon was performed by
preserving its insertion into the first metatarsal, rerouting the tendon
and passing it from medial to lateral through a calcaneal bone tunnel, and
anchoring it to the lateral aspect of the calcaneus. A reconstruction with
the tibialis tendon was performed by passing the medial third of the tendon
from dorsal to plantar through the navicular and from medial to lateral
through the calcaneal bone tunnel and securing it to the lateral aspect of
the calcaneus. The reconstruction with the tibialis anterior tendon was
repeated with the tendon graft routed along the medial aspect of the
navicular, directly through the calcaneal bone tunnel. The fourth
reconstruction was done with use of an Achilles tendon allograft.(ABSTRACT
TRUNCATED AT 250 WORDS)
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