Endoscopic Flexor Halluces Longus transfer for Chronic Achilles Tendon rupture - technique description and early post-operative results

Background: Achilles tendon ruptures may lead to proximal retraction of the stump if not treated acutely, increasing the chances of poorer functional outcomes. The flexor halluces longus transfer is a well-established treatment option, usually performed as an open procedure. The aim of this paper is...

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Bibliographic Details
Authors: Baumfeld, Daniel, Baumfeld, Tiago, Figueiredo, Andre Rocha, de Araujo Junior, Luis Fernando, Macedo, Benjamim, Alves Silva, Thiago Alexandre, Raduan, Fernando, Nery, Caio [UNIFESP]
Format: article
Status:Published version
Publication Date:2017
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/54728
Online Access:http://dx.doi.org/10.11138/mltj/2017.7.2.341
https://repositorio.unifesp.br/handle/11600/54728
Access Level:Open access
Keyword:Achilles tendon rupture
flexor halluces longus transfer
endoscopy
Achilles tendon re-rupture
minimally invasive surgery
Description
Summary:Background: Achilles tendon ruptures may lead to proximal retraction of the stump if not treated acutely, increasing the chances of poorer functional outcomes. The flexor halluces longus transfer is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report the preliminary results and describe the technique of endoscopic flexor halluces longus transfer. Material and methods: Six patients with chronic Achilles tendon injuries or re-ruptures were treated with endoscopic FHL transfer. The Achilles Tendon Rupture Score was used to clinically evaluate the patients. Single leg heel rise ability, functional hallux weakness, complications and procedure length were also checked. Results: On average, we took 56 minutes to perform the surgery. All patients had a major increase in the ATRS score value postoperatively. Single leg heel rise was possible for all patients without limitation. None of the patients noticed functional weakness of the hallux during daily life activity and no wound or soft tissue complications were seen. Conclusion: Endoscopic FLH transfer is a reliable option for patients with high skin risk and soft tissue complications. Other studies are needed to compare this technique with the open procedure, gold standard by now, to ensure its safety and efficacy.