Flexor hallucis longus transfer for neglected and large Achilles tendon rupture

Czech version

Authors: Peter Filan; Radek Hart; Václav Štipčák; Adel Safi
Authors‘ workplace: Department of Orthopaedics and Traumatology, Znojmo Hospital ; Ortopedicko – traumatologické oddělení Nemocnice Znojmo
Published in: Úraz chir. 16., 2008, č.4

Overview

Introduction:
The incidence of the Achilles tendon rupture is growing. The first examining physician misses more than 20 % of such injuries. There was described many techniques of the surgical treatment in cases when standard suture “end to end” is not possible. In our study we have decided to follow up patients treated by the modified procedure according to Keith L. Wapner.

Material:
Since 2004 to 2006 we treated 7 patients with chronic tear of Achilles tendon and 3 patients with an acute injury by modified 2 incisions surgical procedure according to Wapner – flexor hallucis longus tendon transfer.

Methods:
The patients were followed up 6 months after the surgery. Clinical examination using AOFAS Hindfoot score were performed. Subjective satisfaction with the total outcome of the surgery and the perception of eventual limitation of the toe flexion was examined.

Results:
There was no serious complication. The AOFAS Hindfoot score outcomes grown from 27,64 to 89,82 in 6 months after the surgery. Subjectively, 6 patients are satisfied with final effect of the surgery, 3 patients are satisfied partially, 1 patient is dissatisfied.

Discussion:
The surgical treatment of the Achilles tendon rupture can be divided in static (without supporting function of the another muscle) and dynamic (muscle transfer with active function and power). Flexor hallucis longus muscle seems to be optimal for several reasons.

Conclusions:
Wapner technique of flexor hallucis longus tendon transfer is sufficient alternative for treatment of neglected Achilles tendon rupture such as large defects in acute injury without risk of frequent complications. Our modifycation makes the distal fixation of the flexor hallucis longus tendon easier without drilling holes in calcaneus.

Key words:
Achilles tendon rupture, flexor hallucis longus transfer.

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Labels

Surgery Traumatology Trauma surgery

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Article was published in

Trauma Surgery

2008 Issue 4