[Flexor digitorum (hallucis) longus muscle tendon transfer in the repair of old rupture of the Achilles tendon].
OBJECTIVE
To explore the operative technique of repair and its curative effect of old rupture of the Achilles tendon with flexor digitorum (hallucis)longus tendon transfer.


METHODS
From Nov 2001 to May 2005, 13 patients who had old rupture of the Achilles tendon were treated with this operative technique. Five of them were treated with flexor digitorum longus tendon transfer and 8 with flexor hallucis longus tendon. All patients had the history of closed injury of Achilles tendon(9 male and 4 female, 8 left feet and 5 right feet). The age ranged from 32 to 69 years(mean 41 years).


METHODS
flexor digitorum (hallucis)longus tendon was cut down alternatively. The distal end of flexor digitorum longus tendon should be sutured to flexor hallucis longus tendon if the flexor digitorum longus tendon was cut. The distal end of flexor hallucis longus tendon should be sutured to flexor digitorum longus tendon if the flexor hallucis longus tendon was cut. The proximal end of tendon to be cut down was sew up a suture line and pulled out from the incision to reveal the Achilles tendon. A transverse hole was drilled through the anterior aspect of the insertion of the tendon of the calcareous, and then drilled upward perpendicularly. The two holes were cross-connected by towel clamp. The flexor digitorum (hallucis)longus tendon to be transferred was pulled through the first hole from wall outward and upward, and then pulled through superior extremity of the second hole. The end of tendon was sutured firmly with the Achilles tendon.


RESULTS
All patients have no infection or re-rupture during follow-up (average 24 months;range 11 to 54 months). There was no subsequent hammer-toe deformity. Dorsiflexion at least to neutral and normal plantar flexion were obtained in all patients. According to Arner-Lindholm standard,the final results were excellent in 9 patients(6 cases were used flexor hallucis langus tendon, and 3 cases were used flexor digitorum longus tendon),good in 3 patients(2 cases were used flexor hallucis longus tendon and 1 case was used flexor digitorum longus tendon) and poor in 1 patient used with flexor digitorum longus tendon.


CONCLUSIONS
The repair of old rupture of the Achilles tendon with flexor digitorum (hallucis) longus tendon transfer is an ideal and effective method. Furthermore, the use of flexor hallucis longus muscle tendon tends to be more reasonable.
Qu
Jia-fu
JF
Department of Foot & Ankle Surgery, the Second Hospital of Tangshan, Tangshan 063000, Hebei, China. qujiafu2008@sina.com
Cao
Li-hai
LH
Zhao
Hong-bo
HB
Gao
Jian-hua
JH
Li
Shao-guang
SG
Du
Xiao-jian
XJ
Sun
Yang
Y
Peng
Yi
Y
Wang
Liang
L
D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012421:Rupture; D013709:Tendon Transfer / Q000379:methods*