The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons · 2026
Percutaneous long flexor needle tenotomy of toes: a simple, safe, and effective procedure for diabetic foot salvage and intertrigo. Single-centre retrospective cohort study.
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Purushothaman Rajendran, Gupta Prasanna Kumar, Kumar R Vikram
Аннотация
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.
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.