Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

Foot & Ankle

LESS INVASIVE SINGLE INCISION FLEXOR HALLUCIS LONGUS TRANSFER FOR CHRONIC ACHILLES TENDON RUPTURE

British Orthopaedic Foot & Ankle Society (BOFAS)



Abstract

Introduction

Chronic ruptures of the Achilles tendon pose a significant management challenge to the clinician. Numerous methods of surgical reconstruction have been described and are generally associated with a higher complication rate than with immediate repair. We report our results with a single 5cm incision technique to reconstruct chronic Achilles tendon ruptures with transfer of FHL. This simple technique also enables easy tensioning of the graft/reconstruction to match the uninjured leg and early mobilisation.

Materials & Methods

All patients undergoing late Achilles tendon reconstruction (over 4 months from rupture) during the period September 2006 to January 2010 were included in the study. All patients were treated using a single incision technique and posterior ankle FHL harvest with bio absorbable interference screw fixation in the calcaneum. Weight bearing was allowed from 2 weeks post operatively with a dynamic rehabilitation regime identical to that which we use following repair of acute ruptures. A retrospective review of the records was performed and a further telephone review undertaken.

Results

15 ‘late’ Achilles tendon reconstructions were undertaken in the study period. Their mean age was 55 years (38-80). Mean time from rupture was 16 months (5-96). Significant co-morbities included diabetes, chronic renal failure, multiple schlerosis and Parkinson's disease. The mean duration of follow-up was 20 months (7–38). There were no post-operative complications. AOFAS score improved significantly in all patients and all reported good or excellent improvement in strength and return to pre-injury function (including sport in 2 cases).

Conclusion

This less invasive single incision technique of FHL transfer reconstruction of chronic Achilles tendon ruptures as previously published from our unit seems to be a safe and reliable undertaking in patients with symptomatic chronic Achilles ruptures and is our preferred technique for all chronic ruptures especially in the presence of significant co-morbities.