In Jones tenosuspension, what is the primary tendon transfer performed?

• A. Fusion of MTP joint
• B. Transfer of FDL to proximal phalanx
• C. Transfer of EDL to proximal phalanx
• D. Transfer of EHL to proximal phalanx

Answer: (D)

The idea behind Jones tenosuspension is to change the pull of a tendon to create a dynamic sling that raises and stabilizes the toe, realigning it without rigid fusion. The classic move is to transfer the extensor hallucis longus to the proximal phalanx. This tendon is strong, has reliable excursion, and reattaching it to the proximal phalanx places the toe under a new pull that effectively suspends it and corrects deformity at the metatarsophalangeal level. It provides durable correction while preserving much of the toe’s function. Transferring other tendons can be used in different procedures, but for Jones tenosuspension the extensor hallucis longus to the proximal phalanx is the standard, best choice.