Tenodesis effect and digital cascade of the foot were never described in the current literature. However, understanding of these effects are important in the diagnoses and managements of foot flexor tendon rupture and lesser toe deformities. We aim to investigate the presence of these effects in the foot with intact and cut tendons.

Ten fresh frozen cadaveric specimens were used in our study. 2^nd, 3^rdand 4^thtoe metatarsophalangeal joint (MTPJ) and proximal interphalangeal joint (PIPJ) range of motion (ROM) at ankle resting position were measured. Same measurements were repeated with maximum ankle plantarflexion and dorsiflexion. 4^thtoe Flexor Digitorum Longus (FDL) was then identified over plantar aspect of metatarsal shaft and cut transversely. 2^nd, 3^rdand 4^thtoe MTPJ and PIPJ ROM at ankle resting position, maximum plantarflexion and dorsiflexion were then measured.

Mean 4^thtoe MTPJ and PIPJ ROM at ankle dorsiflexion were 13.5 ° of dorsiflexion and 25 ° of plantarflexion respectively, compared with values at ankle plantarflexion which were 35 ° and 25 ° respectively. After 4^thtoe FDL was cut, mean 4^thtoe MTPJ and PIPJ ROM at ankle dorsiflexion were 14 ° and 24 ° respectively and at ankle plantarflexion the values were 34.5 ° and 25 ° respectively. At ankle resting position before 4^thFDL was cut, mean 4^thtoe MTPJ and PIPJ ROM were 22 ° and 31 ° respectively, compared with the values after 4^thFDL was cut, ie 22.5 ° and 30.5 ° respectively.

Tenodesis effect of the foot was shown in our study. However unlike in hand, this effect was only present in MTPJ and was still present following cut FDL. Similarly, digital cascade was still present following cut FDL. The maintenance of tenodesis effect and digital cascade following cut flexor tendon is likely contributed by various soft tissue restraints and intrinsic muscle actions. These findings are important in both the diagnosis and management of foot flexor tendon rupture and help us to better understand the biomechanics of lesser toe deformities and the managements of these deformities.

The aim of this study was to evaluate prospectively the outcome following arthroscopic Bankart repair using two types of suture anchors, absorbable and non-absorbable. Patients with a diagnosis of recurrent traumatic anterior instability of the shoulder, seen between April 2000 and June 2003 in a single unit, were considered for inclusion in the study. Patients were assessed pre-operatively and post-operatively using a subjective patient related outcome measurement tool (Oxford instability score), a visual analogue scale for pain and instability (VAS Pain and VAS instability) and a quality of life questionnaire (SF-12). The incidence of recurrent instability and the level of sporting ability were recorded. Patients were randomised to undergo surgical repair with either non-absorbable or absorbable anchors.

130 patients were included in the study. 6 patients were lost to follow-up and 124 patients (95%) completed the study. Both types of anchors were highly effective. There were no differences in the rate of recurrence or any of the scores between the two. Four patients in the non-absorbable group and 3 in the absorbable group experienced further episodes of dislocation after a traumatic event. The rate of redislocation in the whole series was therefore, 5.6%. In addition, 4 patients, all of them in the absorbable group (4%) described ongoing symptoms of instability but no true dislocations. 85% of the patients have returned to their previous level of sporting activity.

There are no differences in the outcome of Arthroscopic Bankart repair using either absorbable or non-absorbable anchors. Both are highly effective, showing a redislocation rate of 5.6%.