Free Hamstrings Tendon Transfer and Interference Screw Fixation for Less Invasive Reconstruction of Chronic Avulsions of the Achilles Tendon

2012 ◽  
pp. 45-53
Author(s):  
Nicola Maffulli ◽  
Umile Giuseppe Longo ◽  
Filippo Spiezia ◽  
Vincenzo Denaro
Keyword(s):  
Achilles Tendon ◽  
Tendon Transfer ◽  
Screw Fixation ◽  
Interference Screw ◽  
Less Invasive ◽  
Interference Screw Fixation ◽  
Hamstrings Tendon

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

2018 ◽  
Vol 4 (2) ◽  
pp. 227 ◽  
Author(s):  
Athar Ahemad M. A. ◽  
Naser Mohd Abdul ◽  
Mushir Ali Syed
Keyword(s):  
Achilles Tendon ◽  
Tendon Transfer ◽  
Suture Anchor ◽  
Interference Screw ◽  
Flexor Hallucis Longus ◽  
Reliable Technique ◽  
Good Outcome ◽  
Interference Screw Fixation ◽  
Tendon Ruptures

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">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.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">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</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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.</span></p>

Strength of Interference Screw Fixation to Cuboid vs Pulvertaft Weave to Peroneus Brevis for Tibialis Posterior Tendon Transfer for Foot Drop

2018 ◽  
Vol 39 (7) ◽  
pp. 858-864 ◽  
Author(s):  
Daniel Marsland ◽  
Joanna M. Stephen ◽  
Toby Calder ◽  
Andrew A. Amis ◽  
James D. F. Calder
Keyword(s):  
Tendon Transfer ◽  
Screw Fixation ◽  
Insertion Site ◽  
Interference Screw ◽  
Foot Drop ◽  
Tibialis Posterior ◽  
Materials Testing ◽  
Reliable Technique ◽  
Load To Failure ◽  
Interference Screw Fixation

Background: Tibialis posterior (TP) tendon transfer is an effective treatment for foot drop. Currently, standard practice is to immobilize the ankle in a cast for 6 weeks nonweightbearing, risking postoperative stiffness. To assess whether early active dorsiflexion and protected weightbearing could be safe, the current study assessed tendon displacement under cyclic loading and load to failure, comparing the Pulvertaft weave (PW) to interference screw fixation (ISF) in a cadaveric foot model. Methods: Twenty-four cadaveric ankles had TP tendon transfer performed, 12 with the PW technique and 12 with ISF to the cuboid. The TP tendon was cycled 1000 times at 50 to 150 N and then loaded to failure in a materials testing machine. Tendon displacement at the insertion site was recorded every 100 cycles. An independent t test and 2-way analysis of variance were performed to compare techniques, with a significance level of P < .05. Results: Mean tendon displacement was similar in the PW group (2.9 ± 2.5 mm [mean ± SD]) compared with the ISF group (2.4 ± 1.1 mm), P = .35. One specimen in the ISF group failed early by tendon pullout. None of the PW group failed early, although displacement of 8.9 mm was observed in 1 specimen. Mean load to failure was 419.1 ± 82.6 N in the PW group in comparison to 499.4 ± 109.6 N in the ISF group, P = .06. Conclusion: For TP tendon transfer, ISF and PW techniques were comparable, with no differences in tendon displacement after cyclical loading or load to failure. Greater variability was observed in the PW group, suggesting it may be a less reliable technique. Clinical Relevance: The results indicate that early active dorsiflexion and protected weightbearing may be safe for clinical evaluation, with potential benefits for the patient compared with cast immobilization.

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