Flexor hallucis longus tendon transfer for reconstruction of chronically ruptured Achilles tendons
Journal of Orthopaedic Surgery 2009;17(2):194-8
Original article: Purpose. 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; Flexor hallucis longus tendon transfer for reconstruction of chronically ruptured Achilles tendons. 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-tomoderate demands.
