Flexor hallucis longus tendon transfer for reconstruction of chronically ruptured Achilles tendons.
OBJECTIVE
To report the mid-term results of flexor hallucis longus (FHL) tendon transfer for reconstruction of chronically ruptured Achilles tendons.


METHODS
24 men and 12 women aged 56 to 78 (mean, 70) years underwent FHL tendon transfer for reconstruction of chronically ruptured Achilles tendons by a single surgeon. Ruptures were secondary to trauma (n=20), long-term steroid intake (n=12), or chronic renal failure (n=6). Two patients had bilateral ruptures. The mean interval from rupture to surgery was 15 (range, 12-24) weeks. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores were compared. Wound healing, push-off, and patient satisfaction were evaluated.


RESULTS
The mean follow-up period was one year. The mean AOFAS scores were 69 (range, 58-76) preoperatively and 88 (range, 79-94) postoperatively; the mean improvement was 19 (p<0.001). 28 patients had excellent and 8 had fair results. 33 patients graded their outcome as 'very satisfactory' and 3 as 'satisfactory'. Five patients developed wound healing complications but only one needed debridement. There was no fixation-related complication or sural nerve injury.


CONCLUSIONS
Transfer of the FHL for reconstruction of chronically ruptured Achilles tendons is effective, safe and easily performed in patients with low-to-moderate demands.
Mahajan
Ravindra H
RH
Department Of Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, United Kingdom. drtanu_mhas@hotmail.com
Dalal
Rakesh B
RB
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012421:Rupture; D013708:Tendon Injuries / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing