PMC5974681_01
Clinical appearance of foot before surgery. (a) Loss of longitudinal arch in Rt. foot. (b) Non-weight-bearing picture showing flat-foot.
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F1
The physical examination revealed plantigrade feet, with a distinctly right flatfoot with a well-formed longitudinal arch on the left side (Fig. 1).
Findings at surgery: Flexor hallucis longus (FHL) has been sutured to navicular, and tibialis posterior tendon stump (black arrow), and distal end of FHL is ready to be sutured to flexor digitorum longus (white arrow).
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F2
FHL was tightly sutured to the FDL (Fig. 2 and 3). Following 6 weeks of cast immobilization a course of physiotherapy was started (Fig. 4).
Schematic description ofsurgical finding (a), and the transfer (b).
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F3
FHL was tightly sutured to the FDL (Fig. 2 and 3). Following 6 weeks of cast immobilization a course of physiotherapy was started (Fig. 4).
Foot-6 weeks post-tendon transfer.
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F4
FHL was tightly sutured to the FDL (Fig. 2 and 3). Following 6 weeks of cast immobilization a course of physiotherapy was started (Fig. 4).
3 years post-tendon transfer: (a) Clinical appearance of foot in standing position. (b) Lateral radiography-patient on tiptoes, showing good longitudinal arch.
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F5
The longitudinal arch was restored and has remained nicely intact up to the last visit 3 years post-surgery (Fig. 5).