Reconstruction of Neglected Achilles Tendon Rupture with Flexor Hallucis Longus Augmentation Using One Incision Technique.
- Author:
Kwang Hwan PARK
1
;
Bom Soo KIM
;
Jin Woo LEE
Author Information
1. Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea. ljwos@yuhs.ac
- Publication Type:Original Article
- Keywords:
Neglected Achilles tendon rupture;
One incision;
Flexor hallucis longus tendon transfer
- MeSH:
Achilles Tendon;
Animals;
Ankle;
Debridement;
Follow-Up Studies;
Foot;
Heel;
Humans;
Orthopedics;
Rupture;
Tendon Transfer;
Tendons
- From:Journal of Korean Foot and Ankle Society
2009;13(1):23-27
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. MATERIALS AND METHODS:Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. RESULTS:The length of the gap after debridement was 5.4+/-2.0 cm. The VAS improved from 4.1+/-0.9 to 1.5+/-0.8 at last follow up (p<0.05). The AOFAS score increased from 38.9+/-12.2 to 91.5+/-8.9 at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. CONCLUSION: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.
