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

Foot Ankle Surg. 2019 Oct;25(5):630-635. doi: 10.1016/j.fas.2018.07.002. Epub 2018 Jul 18.

Abstract

Background: The transfer of Flexor Hallucis Longus Tendon (FHL) is an established method for the treatment of chronic Achilles tendon ruptures. An extensive examination of power, strength, endurance and complications related to this procedure is presented.

Methods: 21 patients treated with open FHL transfer for chronic Achilles tendon rupture were studied retrospectively. Medical records were reviewed. The patients were examined with a test battery for triceps surae strength, functional tests and PROMs.

Results: The median maximal concentric strength was equal,1300 vs 1336W, comparing affected with unaffected side. The endurance tests showed a larger difference, 219J vs. 2398J, respectively. The median AOFAS score was 87. 11 of 21 patients sustained one or more complications; the most common were infection, disturbed wound healing, and clawing of small toes.

Conclusions: Patients achieve almost normal maximal strength after open FHL transfer, but endurance is notably lower. The complication rate was high.

Keywords: Chronic Achilles rupture; Complications; FHL tendon transfer; Functional outcome.

MeSH terms

  • Achilles Tendon / injuries*
  • Achilles Tendon / surgery*
  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Postoperative Complications
  • Retrospective Studies
  • Rupture / surgery
  • Tendon Transfer / methods*