Diabetic foot ulcers are a common and serious problem for people with diabetes. These ulcers, especially those that form at the tip of the toes, can be painful, difficult to treat, and may even lead to amputations. One of the causes of these ulcers is toe deformities, such as claw toes, which create extra pressure on the toes and make it hard to heal. A treatment called flexor tenotomy has been found to help relieve this pressure and speed up healing, especially for people with diabetes.
What is Flexor Tenotomy?
Flexor tenotomy is a simple, minimally invasive procedure that involves cutting certain tendons in the toes. Tendons are tissues that connect muscles to bones. In this procedure, the tendons that help bend the toes are cut to straighten the toe. This straightening reduces the pressure on the tip of the toe, where ulcers often develop. Flexor tenotomy is a small procedure that can be done in a doctor’s office with a local anesthetic, meaning it doesn’t require a hospital stay or general anesthesia.
How Effective is Flexor Tenotomy?
Studies show that flexor tenotomy is very effective in treating diabetic foot ulcers. The healing rates for people who have this procedure range from 92% to 100%, and most people see their ulcers heal within 2 to 4 weeks. For people who have ulcers on their toes, the procedure speeds up healing and prevents new ulcers from forming. In one study, the average healing time for ulcers was just 10 days. This is much faster compared to other treatments, which can take weeks or even months​.
Flexor tenotomy is also used as a preventive measure for people at risk of developing ulcers. For example, if a person has a preulcerative condition (a condition that could lead to an ulcer), the procedure can stop it from turning into a full-blown ulcer. This makes it a helpful tool for managing foot health in people with diabetes.
Risks and Side Effects
While flexor tenotomy is generally safe, there are a few risks. One of the most common issues is a “transfer lesion.” This happens when the pressure that was once on one toe shifts to another toe, potentially causing a new ulcer on the adjacent toe. This risk is greater if only one toe is treated with tenotomy. However, treating all affected toes at the same time can prevent this problem​.
Infections at the site of the surgery are rare but can occur. If an infection happens, it can usually be treated with antibiotics. Overall, the risk of complications is low, and the procedure has been shown to be both safe and effective​.
Patient Satisfaction
People who undergo flexor tenotomy are generally very satisfied with the results. They report less pain, faster healing, and better overall foot health. The procedure can be done in an outpatient setting, meaning there’s no need for hospitalization or surgery under general anesthesia, which is especially beneficial for older adults or people with other health problems. Patients appreciate how quick and easy the procedure is compared to other treatments that might require longer recovery times or hospital stays​.
Long-Term Results
It’s important for patients to have regular follow-up visits after the procedure to make sure the healing continues and that no new problems, like transfer lesions, develop. Most studies have shown that ulcers do not return once healed, and the toes remain in better condition after the procedure​​.
Conclusion
Flexor tenotomy is a fast and effective treatment for diabetic foot ulcers, particularly those at the tips of the toes. It helps heal existing ulcers and can prevent future ones from forming. The procedure is minimally invasive, quick, and safe, with very few risks. If you or a loved one has diabetes and suffers from toe ulcers, flexor tenotomy might be an excellent option to consider for improving foot health and preventing more serious complications like amputations. It’s a great example of how a small procedure can make a big difference in the management of diabetes-related foot problems.
Do you have more questions?
Q. What is Flexor Tenotomy?
A. Flexor Tenotomy is a minimally invasive procedure where tendons in the toes are cut to straighten them and reduce pressure, particularly useful for treating diabetic foot ulcers at the tips of the toes.
Q. How is Flexor Tenotomy performed?
A. The procedure is done in a doctor’s office with a local anesthetic. The tendons responsible for bending the toes are cut to straighten the affected toes, reducing pressure that causes ulcers.
Q. How effective is Flexor Tenotomy for diabetic foot ulcers?
A. Flexor Tenotomy is highly effective, with healing rates ranging from 92% to 100%. Most ulcers heal within 2 to 4 weeks, with some healing in as little as 10 days.
Q. What are the risks associated with Flexor Tenotomy?
A. The main risk is the development of “transfer lesions,” where pressure moves to another toe, possibly causing a new ulcer. Infections are rare but may require antibiotic treatment.
Q. Is Flexor Tenotomy a permanent solution for diabetic foot ulcers?
A. While the procedure is highly effective in healing existing ulcers and preventing new ones, follow-up care is important to ensure proper healing and avoid complications like transfer lesions.
Q. What conditions can Flexor Tenotomy treat?
A. Flexor Tenotomy is primarily used to treat diabetic foot ulcers caused by pressure on the toes, but it can also be beneficial for conditions involving hammertoes or contracted toes.
Q. How long does the Flexor Tenotomy procedure take?
A. The procedure typically takes about 15 to 20 minutes and is performed on an outpatient basis with local anesthesia.
Q. Will I need to stay in the hospital after Flexor Tenotomy?
A. No, Flexor Tenotomy is an outpatient procedure, meaning you can go home the same day after the procedure is completed.
Q. How long does it take to recover from Flexor Tenotomy?
A. Recovery is usually quick, with most patients able to resume normal activities within a few days. The toe may be sore for a short time, but there is typically no need for prolonged rest.
Q. Can Flexor Tenotomy be done on both feet at the same time?
A. Yes, Flexor Tenotomy can be performed on both feet at the same time, but the decision is based on the patient’s health and the extent of the condition being treated.
Q. Will I need any follow-up care after Flexor Tenotomy?
A. Follow-up care typically involves monitoring the healing process, including checking for infection or new pressure points, and ensuring that any ulcers have fully healed.
Q. Are there any long-term complications from Flexor Tenotomy?
A. Long-term complications are rare, but some patients may develop transfer lesions where pressure shifts to other toes. Regular foot care and monitoring are essential to prevent these issues.
Q. Can Flexor Tenotomy help prevent future ulcers?
A. Yes, by correcting the position of the toes and alleviating pressure, Flexor Tenotomy can help prevent the formation of future ulcers, especially in patients with diabetes.
Q. Is Flexor Tenotomy suitable for patients with other foot deformities?
A. Flexor Tenotomy is effective for patients with conditions like hammertoes or toe contractures, especially when they are contributing to foot ulcers or other issues.
Q. Does Flexor Tenotomy affect the function of my toes?
A. The procedure generally does not impair toe function; in fact, it improves the alignment of the toes, which can help improve mobility and reduce pain. However, there is a slight risk of weakness or stiffness after the surgery.
Dr. Mo Athar
