title: Chronic Achilles tendon rupture treated with two turndown flaps and flexor hallucis longus augmentation - two-year clinical outcome.
abstract: BACKGROUND
  Both conservative and operative management have been described in the literature for the management of chronic Achilles tendon ruptures with surgical management generally having more favourable results. In our institution, the favoured reconstructive technique was the use of 2 turndown tendon fl aps fashioned from the proximal Achilles tendon augmented by a tenomyodesis of the flexor hallucis longus. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure.
  
  
  METHODS
  From the records, a total of 9 patients underwent the above-mentioned procedure of whom 6 patients had complete data collection sets [including SF-36, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, ankle range of motion (ROM), presence of residual symptoms and complications] at 2 years of follow-up.
  
  
  RESULTS
  Our results showed an average AOFAS Ankle-Hindfoot score of 94.2, VAS of 0 in all but 1 patient, and generally high scores (75-96) in all 8 domains of the SF-36 questionnaire. Patient satisfaction was also rated to be high from the surgical procedure.
  
  
  CONCLUSIONS
  We submit that the procedure adopted at our institution is able to reproduce satisfactory results with low morbidity in patients with this challenging condition.
authors.affiliation: 1Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. darren1414@gmail.com
authors.forename: Darren
authors.initials: D
authors.lastname: Tay
authors.forename: Heng An
authors.initials: HA
authors.lastname: Lin
authors.forename: Benjamin Sa
authors.initials: BS
authors.lastname: Tan
authors.forename: Keen Wai
authors.initials: KW
authors.lastname: Chong
authors.forename: Inderjeet Singh
authors.initials: IS
authors.lastname: Rikhraj
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods* / Q000534:rehabilitation; D017060:Patient Satisfaction; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous