1) The theory is to enable the FDL tendon to assume the function of the intrinsic musculature (plantar flexion of the MTPJ and extension of the interphalangeal joint).
The physical exam showed edema and tenderness localized to the left second toe, second MTPJ and second metatarsal head.
The dorsomedial incision, with care taken to protect the distal continuation of the medial dorsal cutaneous nerve, was the surgeon's preference to reduce shoe friction (associated with a medial incision) and allowed access to the lateral first MTPJ structures.
The second MTPJ capsulotomy was performed in order to satisfactorily realign the second toe.
She continues to have mild pain plantar to the second metatarsal head when standing in releve, but suffered no limitation in dorsiflexion at the first or second MTPJ.
Although our review of the literature presented many cases of chronic second MTPJ rupture, much less attention has been given to acute MTPJ disruption.
The theory behind the flexor tendon transfer is that it enables the long toe flexors to assume the function of the intrinsic musculature, therefore providing a dynamic force in plantar flexion at the MTPJ.