1.Flexor Hallucis Longus Transfer And V-Y Plasty: An Effective Treatment Modality for Chronic Achilles Rupture - A Case Series
Rashid RH ; Ali R ; Zahid M ; Ali M ; Ahmad T
Malaysian Orthopaedic Journal 2023;17(No.3):59-65
Introduction: To assess outcomes of FHL transfer and V-Y
plasty for chronic Achilles rupture due to insertional Achilles
tendinopathy.
Materials and methods: A case series of 12 patients was
conducted between 1st January 2017 and 31st December
2018. The patients had short flexor hallucis longus tendon
transfer with gastrocnemius lengthening by V-Y plasty for
Achilles tendon rupture. Patients were allowed full weight
bearing at six weeks post-operatively, and were followed up
at three months and six months post-operatively, when the
range of motion of the ankle was examined, and the outcome
was assessed using the EFAS score.
Results: Of the 12 patients in the study, the majority were
males; the mean age was 50.6±8.96 years. A significant
improvement in dorsiflexion and plantarflexion was noted at
the six-month follow-up compared to the three-month
follow-up (P=<0.001 for both). When compared to the
normal side, dorsiflexion and plantarflexion of the affected
ankle were significantly less at three months but were
comparable at six months post-operatively. A significant
improvement was noted in the mean EFAS score at the sixmonth follow-up (25.5±5.71) compared to three months
(18.6±0.90) post-surgery (P=0.001). Males were also noted
to have significantly higher EFAS scores at their six-month
follow-up than females (P=0.022). In contrast, a negative
correlation was noted between the European Foot and Ankle
Society (EFAS) score at the final follow-up and age
(P=0.011).
Conclusion: FHL tendon transfer with V-Y plasty in chronic
Achilles rupture due to insertional Achilles tendinopathy is
an effective procedure resulting in the restoration of the
ankle range of motion and improvement in functional scores.


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