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Achilles Tendon Reconstruction and Flexor Hallucis Longus Transfer

March 01, 2017

Contributors: Sanjit R Konda, MD; Kenneth A Egol, MD; Nina Fisher, BS; Hesham Saleh, BS

Introduction: This case presentation demonstrates the technique of Achilles tendon reconstruction with a flexus hallucis longus (FHL) transfer. Methods: The patient is a 52-year-old male who is nine months status post a motorcycle accident complaining of persistent posterior right ankle pain. On physical exam, he has a bulbous deformity about the distal aspect of the Achilles tendon with a palpable 4 cm gap at the midsubstance of his Achilles tendon. An MRI reveals a complete tendon rupture 3 cm proximal to the calcaneal tuberosity with a 4.5 cm retraction. Results: Given the chronicity of the rupture, the extent of tendon retraction, and the patient’s disability, the patient is indicated for reconstruction of the plantarflexion mechanism of his ankle joint with an achilles tendon reconstruction with cadaveric allograft and augmentation with a flexor hallucis longus tendon transfer. Conclusion: The technique of Achilles tendon reconstruction with Achilles tendon allograft and augmentation with FHL transfer provides a robust plantarflexion mechanism to the ankle that adheres to the principle of restoring native muscle-tendon length relationship. The augmentation aspect with the FHL serves as both an internal brace to maintain the allograft-native tendon repair during the rehabilitation process as well as an active muscle unit to aid in plantarflexion strength.

Results for "Foot & Ankle"

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1 of 6