Pearls & Pitfalls
Harvest the graft with the ankle in maximal plantarflexion with the Great Toe hyperflexed in order to get a graft with an apropriate lenght.
The grasper to pick up the FHL and the scissors or knife N 11 are introduce through the same PM portal. Cut the FHLTendon as far distal as posible.
Perform an endoscopic calcaneoplasty in ALL PATIENTS in order to place the calcaneal tunnel at the correct position and introduce the screw under direct arthroscopic visualization.
Fix the graft in neutral position (if we fix the tendon transfer in plantarflexion a loss of dorsiflexión can occur in the postoperative )
To cut the FHLT incompletelly
Iatrogenic lesions on posterior tibial neurovascular structures