Repair of Chronic Achilles Tendon Rupture with Flexor Hallucis Longus Tendon Transfer

TLDR

The study introduces a novel flexor hallucis longus tendon transfer technique for reconstructing chronic Achilles tendon ruptures. The technique was evaluated in seven patients (mean age 52) with an average 17‑month follow‑up, assessing ankle and toe range of motion, scar healing, sensation, motor strength via Cybex, and patient satisfaction through questionnaires. All patients experienced no infections, skin loss, or re‑ruptures, had only minor, functionally insignificant range‑of‑motion deficits, and achieved satisfactory functional recovery, with one patient requiring an orthosis for extended ambulation yet still able to play golf.

Abstract

A new technique is described for reconstruction of chronic Achilles tendon rupture using the flexor hallucis longus tendon. Follow-up on seven patients (mean age 52 years) is provided (average follow-up 17 months, range 3–30 months). All patients were re-examined to assess postoperative range of motion, scar healing, and sensation. Motor strength was assessed by Cybex testing. Subjective satisfaction was examined by completion of a questionnaire. There were no postoperative infections, skin losses, or re-ruptures. Each patient developed a small but functionally insignificant loss in range of motion in the involved ankle and great toe. All patients had a satisfactory return of function. One patient required a molded foot-ankle orthosis for extended ambulation but was able to play golf.