title: Biotenodesis screw for fixation of FDL transfer in the treatment of adult acquired flatfoot deformity.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Foot and Ankle Surgery, Roesch-Taylor Medical Building Suite 7300, 2100 Jane Street, Pittsburgh, PA 15203, USA. wukichdk@upmc.edu
authors.forename: Dane K
authors.initials: DK
authors.lastname: Wukich
authors.forename: Bora
authors.initials: B
authors.lastname: Rhim
authors.forename: Nicholas James
authors.initials: NJ
authors.lastname: Lowery
authors.forename: Dekarlos
authors.initials: D
authors.lastname: Dial
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D000328:Adult; D001174:Arthrodesis / Q000379:methods; D001863:Bone Screws; D002111:Calcaneus / Q000601:surgery; D005413:Flatfoot / Q000601:surgery*; D005531:Foot Deformities, Acquired / Q000601:surgery*; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome