Biomechanical Cadaveric Analysis of Biotenodesis Screw Versus Bone Tunnel Fixation Methods in Flexor Hallucis Longus Transfers

2013 ◽  
Author(s):  
B. Christian Balldin ◽  
Jacob R. Zide ◽  
George T. Liu ◽  
Christopher T. Chen
Keyword(s):  
Achilles Tendon ◽  
Human Body ◽  
Gold Standard ◽  
Tendon Transfer ◽  
Primary Repair ◽  
Bone Tunnel ◽  
Flexor Hallucis Longus ◽  
Fixation Methods ◽  
Tendon Ruptures ◽  
Cadaveric Analysis

The Achilles tendon is the largest tendon in the human body. It connects the gastrosoleus complex to the calcaneus bone in the foot. It thus allows for transfer of force and heel elevation during forward propulsion of the foot in gait. It is also one the most commonly injured tendons. (1). Acute repair or acute intervention for non-operatively treated tendons do well to restore function. However, chronic Achilles tendon ruptures often require tendon transfer rather than attempt at primary repair. The treatment considered the gold standard is the transfer of the flexor hallucis longus (FHL) tendon to the Achilles insertion of the calcaneus (2).

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>

Endoscopic Flexor Hallucis Longus Transfer for the Management of Acute Achilles Tendon Ruptures in Professional Soccer Players

2021 ◽  
pp. 107110072110364
Author(s):  
Nasef Mohamed N. Abdelatif ◽  
Jorge Pablo Batista
Keyword(s):  
Achilles Tendon ◽  
Tendon Transfer ◽  
Case Series ◽  
Return To Play ◽  
Soccer Players ◽  
Flexor Hallucis Longus ◽  
Professional Soccer ◽  
Case Series Study ◽  
Tendon Ruptures ◽  
The Mean

Background: Acute Achilles tendon ruptures (AATRs) that occur in athletes can be a career-ending injury. The aim of this study was to describe return to play and clinical outcomes of isolated endoscopic flexor hallucis longus (FHL) transfer in active soccer players with AATR. Methods: Twenty-seven active male soccer players who underwent endoscopically assisted FHL tendon transfer for acute Achilles tendon ruptures were included in this study. Follow up was 46.2 (±10.9) months after surgery. Return to play criteria and clinical outcome measures were evaluated. Results: All players returned to playing professional competitive soccer games. Return to active team training was at a mean of 5.8 (±1.1) months postoperatively. However, return to active competitive match play occurred at a mean of 8.3 (±1.4) months. Twenty-two players (82%) were able to return to their preinjury levels and performances and resumed their professional careers at the same soccer club as their preinjury state. One player (3.7%) shifted his career to professional indoor soccer. At 26 months postoperatively, the mean Tegner activity scale score was 9.7 (±0.4), the mean Achilles tendon total rupture score was 99 (±2), and the mean American Orthopaedic Foot & Ankle Society ankle-hindfoot score was 99 (±3). No patients reported any great toe complaints or symptomatic deficits of flexion strength. Conclusion: The current study demonstrated satisfactory and comparable return to play criteria and clinical results with minimal complications when using an advanced endoscopically assisted technique involving FHL tendon transfer to treat acute Achilles tendon ruptures in this specific subset of patient cohort. Level of Evidence: Level II, prospective cohort case series study.

scholarly journals Flexor hallucis longus tendon transfer for chronic Achilles tendon rupture. A retrospective study

2019 ◽  
Vol 25 (5) ◽  
pp. 630-635 ◽  
Author(s):  
Ole Kristian Alhaug ◽  
Gøran Berdal ◽  
Elisabeth Ellingsen Husebye ◽  
Kjetil Hvaal
Keyword(s):  
Retrospective Study ◽  
Achilles Tendon ◽  
Tendon Transfer ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Flexor Hallucis Longus ◽  
Longus Tendon

scholarly journals Novel Techniques in Treating Calcaneal Tuberosity Fractures

2014 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Selene G Parekh ◽  
Todd Bertrand ◽  
Robert Zura ◽  
Samuel Adams ◽  
Alan Yan
Keyword(s):  
Internal Fixation ◽  
Achilles Tendon ◽  
Open Reduction ◽  
Tendon Transfer ◽  
Flexor Hallucis Longus ◽  
Suture Anchors ◽  
Calcaneal Fractures ◽  
Longus Tendon ◽  
K Wires ◽  
Calcaneal Tuberosity

ABSTRACT Calcaneal tuberosity fractures comprise only 1 to 2% of all calcaneal fractures. Treatment of these injuries has traditionally included open reduction and internal fixation with various means including lag screws, suture anchors and K-wires. We report on a series of cases treated with excision of the tuberosity fragment with repair of the Achilles tendon supplemented by a flexor hallucis longus tendon transfer. Parekh S, Bertrand T, Zura R, Adams S, Yan A. Novel Techniques in Treating Calcaneal Tuberosity Fractures. The Duke Orthop J 2014;4(1):3-7.

Less-Invasive Reconstruction of Chronic Achilles Tendon Ruptures Using a Peroneus Brevis Tendon Transfer

2010 ◽  
Vol 38 (11) ◽  
pp. 2304-2312 ◽  
Author(s):  
Nicola Maffulli ◽  
Filippo Spiezia ◽  
Umile Giuseppe Longo ◽  
Vincenzo Denaro
Keyword(s):  
Achilles Tendon ◽  
Tendon Transfer ◽  
Less Invasive ◽  
Tendon Ruptures ◽  
Peroneus Brevis

Repair of Chronic Achilles Ruptures Has a High Incidence of Venous Thromboembolism

2016 ◽  
Vol 10 (5) ◽  
pp. 415-420 ◽  
Author(s):  
Mark J. Bullock ◽  
William T. DeCarbo ◽  
Mark H. Hofbauer ◽  
Joshua D. Thun
Keyword(s):  
Venous Thromboembolism ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Achilles Tendon Repair ◽  
Elective Repair ◽  
High Incidence ◽  
Tendon Ruptures

Background. Despite the low incidence of deep vein thrombosis (DVT) in foot and ankle surgery, some authors report a high incidence of symptomatic DVT following Achilles tendon rupture. The purpose of this study was to identify DVT risk factors inherent to Achilles tendon repair to determine which patients may benefit from prophylaxis. Methods. One hundred and thirteen patient charts were reviewed following elective and nonelective Achilles tendon repair. For elective repair of insertional or noninsertional Achilles tendinopathy, parameters examined included lateral versus prone positioning and the presence versus absence of a flexor hallucis longus transfer. For nonelective repair, acute Achilles tendon ruptures were compared to chronic Achilles tendon ruptures. Results. Of 113 Achilles tendon repairs, 3 venous thromboembolism (VTE) events (2.65%) occurred including 2 pulmonary emboli (1.77%). Seventeen of these repairs were chronic Achilles tendon ruptures, and all 3 VTE events (17.6%) occurred within this subgroup. Elevated body mass index was associated with VTE in patients with chronic Achilles ruptures although this did not reach significance ( P = .064). No VTE events were reported after repair of 28 acute tendon ruptures or after 68 elective repairs of tendinopathy. Two patients with misdiagnosed partial Achilles tendon tears were excluded because they experienced a VTE event 3 weeks and 5 weeks after injury, prior to surgery. Conclusion. In our retrospective review, chronic Achilles ruptures had a statistically significant higher incidence of VTE compared with acute Achilles ruptures ( P = .048) or elective repair ( P = .0069). Pharmaceutical anticoagulation may be considered for repair of chronic ruptures. Repair of acute ruptures and elective repair may not warrant routine prophylaxis due to a lower incidence of VTE. Levels of Evidence: Prognostic, Level III: Case Control Study

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