Flexor hallucis longus tendon transfer in the reconstruction of extensive insertional Achilles tendinopathy in elderly: an improved technique

El-Tantawy, Ahmad; Azzam, Wael

doi:10.1007/s00590-014-1569-y

Cited by 19 publications

(9 citation statements)

References 27 publications

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“…Besides that, the normal muscle balance of the ankle is maintained, since a muscle with the same function is being transferred, which is not the case with PB transposition. Passing the tendon through the tunnel in the heel bone enables excellent fixation, which makes early mobilization, early body weight support and passive exercise possible (17).…”

Section: Discussionmentioning

confidence: 99%

Chronic partial rupture of the Achilles tendon: The Flexor Hallucis Longus (FHL) tendon transfer: A report of two cases

Mitrović¹,

Jelača²,

Mitrović³

2020

Acta fac medic Naissensis

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Achilles tendon injuries most commonly occur in athletes, but also in the middle-aged population practicing recreational sports. The aetiology of injury and disease of the Achilles tendon has not been completely clarified. While acute injury can be attributed to trauma, research showed that a chronic degenerative process is present in most ruptures. While there are still a lot of dilemmas when it comes to treating acute rupture, chronic rupture and disease are predominantly treated operatively. Many operative procedures can be used when treating chronic Achilles tendon diseases, such as excision of degenerative changes and tendon decompression, reconstruction using fascia lata and VY plastics, tendon transfer (Flexor Hallucis Longus - FHL, Flexor Digitorum Longus - FDL, Peroneus Brevis - PB) and allograft and synthetic graft reconstruction. The objective of the paper was to present the results of treating chronic partial Achilles tendon rupture by scar excision and FHL tendon transposition. The patients were one professional and one recreational athlete, both of whom were treated nonoperatively for a long time. They were both tested using AOFAS and ATRS tests preoperatively and postoperatively. The results showed a significant improvement of function and both patients were able to return to their usual activities. Postoperative results of AOFAS and ATRS tests were almost identical to the result on the uninjured leg. Our little series, as well as a lot of research performed by other authors, shows that an FHL tendon transposition is a safe and efficient method in treating diseases and injuries of the Achilles tendon.

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Section: Discussionmentioning

confidence: 99%

Chronic partial rupture of the Achilles tendon: The Flexor Hallucis Longus (FHL) tendon transfer: A report of two cases

Mitrović¹,

Jelača²,

Mitrović³

2020

Acta fac medic Naissensis

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“…Já em outro estudo (15) , em parte dos pacientes a transferência do FLH foi feita através de túnel transósseo no calcâneo e na outra foi realizada técnica transtendínea. Além disso, no trabalho de El-Tantawy et al (3) , que obteve um escore AOFAS final de 98.3 pontos, o número de participantes foi de 13 pacientes e um acompanhamento médio de 24.5 meses.…”

Section: Discussionunclassified

“…Nosso estudo apresenta como limitações sua natureza retrospectiva e um número não muito elevado de pacientes, porém compatível com a maioria dos estudos da literatura (3,9,10,17,19) . Além disso, os participantes do estudo apresentavam duas patologias distintas em relação à etiologia da lesão, entesopatia insercional e ruptura crônica do tendão calcâneo.…”

Section: Discussionunclassified

“…A tendinopatia de Aquiles pode ser acarretada pela entesopatia insercional ou pela ruptura crônica do tendão, sendo uma patologia corriqueira. Os pacientes costumam sentir dor persistente na região posterior do calcanhar, geralmente no início e após o término do exercício, podendo tornar-se incapacitante, particularmente em corredores (1)(2)(3)(4)(5) .…”

Section: Introductionunclassified

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Evaluation of the results of flexor hallucis longus tendon transfer for chronic Achilles tendinopathy

2018

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Objective: To demonstrate that transfer of the flexor hallucis longus (FHL) through a single access site for Achilles tendinosis provides good results and can allow satisfactory recovery of ankle flexion strength. Methods: This is a case-control study with 28 consecutive patients who underwent surgery for Achilles tendon debridement and FHL transfer between January 2009 and July 2015. The patients’ body mass index (BMI), plantar flexion strength and ankle dorsiflexion strength were assessed using an isokinetic dynamometer (Humac Norm model, CSMi) and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. Results: Of the 28 patients, 53.8% were women, and the mean age was 55 years. After a median follow-up of 3.1 years, the plantar flexion strength of the operated ankles was 26.42 Nm (± 2.18), and the dorsiflexion strength was 16 Nm (± 1.99). The final AOFAS score was 85.3 points, with 82.1%of patients achieving good and excellent results. The results showed a significant difference in plantar flexion strength (p=0.0001) between the operated foot and the contralateral foot. No significant difference was found when comparing patients with different BMIs in relation to muscle strength and AOFAS score.Conclusion: FHL transfer surgery using a single posteromedial route for chronic Achilles tendinopathy presents good functional results and is a safe technique with a low complication rate. Level of Evidence III; Therapeutic Studies; Case Control Study.

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“…We did not immobilize the ankle in excessive plantar flexion but only in gravity equinus equal to the opposite side. 12 It is important to meticulously repair the paratenon with polyglactin 2-0 since it facilitates the healing response and avoids wound healing problems. No repeat rupture was seen in any of the cases.…”

Section: Discussionmentioning

confidence: 99%

Chronic insertional achilles tendon ruptures treated by suture anchor repair and augmentation with flexor hallucis longus tendon transfer

2018

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Background: Different surgical procedures have been used for treatment of chronic ruptures of the Achilles tendon with varying results. This study assesses the functional outcomes and complications of chronic insertional tears of Achilles tendon.Methods: 10 patients with chronic ruptures of the Achilles tendon were followed for a mean period of 10.3 months. Only ruptures at or near (within 1 cm) insertion were included. They were treated by direct repair of tendon to calcaneum by suture anchor. Flexor hallucis longus (FHL) tendon transfer fixed to calcaneal tunnel with an interference screw was used to augment the repair.Results: Outcome was assessed by AOFAS Ankle-Hindfoot (AHS) score. The mean preoperative score of 41.2 improved to 85.4 at final follow-up out of a total 100 points. We achieved excellent results in 80% and good outcome in 20% cases. No re-ruptures were noted. Conclusions: In insertional chronic ruptures of Achilles tendon, FHL transfer to calcaneum with interference screw fixation and repair of Achilles tendon with suture anchor is a reliable technique with good outcome and is recommended.

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Flexor hallucis longus tendon transfer in the reconstruction of extensive insertional Achilles tendinopathy in elderly: an improved technique

Cited by 19 publications

References 27 publications

Chronic partial rupture of the Achilles tendon: The Flexor Hallucis Longus (FHL) tendon transfer: A report of two cases

Chronic partial rupture of the Achilles tendon: The Flexor Hallucis Longus (FHL) tendon transfer: A report of two cases

Evaluation of the results of flexor hallucis longus tendon transfer for chronic Achilles tendinopathy

Chronic insertional achilles tendon ruptures treated by suture anchor repair and augmentation with flexor hallucis longus tendon transfer

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