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Endoscopic Flexor Hallucis Longus Transfer For The Management Of Acute Achilles Tendon Ruptures. A Prospective Case Series Report With A Minimum Of Eighteen Months Follow Up.

2021 Congress Paper Abstracts

Endoscopic Flexor Hallucis Longus Transfer For The Management Of Acute Achilles Tendon Ruptures. A Prospective Case Series Report With A Minimum Of Eighteen Months Follow Up.

Nasef Mohamed N. Abdelatif, MD, PhD, EGYPT Jorge Pablo Batista, MD, ARGENTINA Javier Del Vecchio, MD, MBA, ARGENTINA Pedro Diniz, MD, PORTUGAL Hélder M. D. Pereira, Prof.,MD, PhD., PORTUGAL

DrNasef OrthoClinic and Centro Arthroscopica Jorge Batista and Universidad Favaloro, Cairo Buenos Aries Porto, EGYPT


2021 Congress   ePoster Presentation     rating (1)

 

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Summary: Acute Achilles tendon rupture (AATR) can be treated with either surgical or nonsurgical options. The aim of this study was to describe clinical outcomes of isolated endoscopic FHL transfer in patients with acute Achilles tendon ruptures at a minimum followup period of eighteen months. Magnetic resonance images were obtained preoperatively, at one week, and one and a half years postoperatively.


Background

Acute Achilles tendon rupture (AATR) can be treated with either surgical or nonsurgical options. The flexor hallucis longus (FHL) has been used to augment the Achilles tendon in patients with Achilles tendinosis and large chronic defects. The aim of this study was to describe clinical outcomes of isolated endoscopic FHL transfer in patients with acute Achilles tendon ruptures at a minimum followup period of eighteen months.

Methods

Fifty-six male patients with an average age of 36.3 years who underwent endoscopic Flexor Hallucis Longus transfer as a treatment for acute Achilles tendon ruptures were included in this study. Followup was for a median of 27.5 +/-7.29 (range, 18 to 43) months after surgery. Magnetic resonance images were obtained preoperatively, at one week, and one and a half years postoperatively. Also, Hallux dynamometry, Ankle plantar flexion strength, Achilles tendon length using Achilles tendon resting angle (ATRA) in addition to Achilles tendon rupture scores (ATRS), AOFAS and VAS scores were documented for all patients also at 18 months postoperatively. MRI performed at a minimum of eighteen months postoperative showed a homogenous continuous signal for 43 patients, and heterogenous signal intensity in 13 patients (23.21%). ATRS median was 95+/-4.26 , while AOFAS score was a mean of 96.4(+/-4.31). Median value for FHL tendon dynamometry at the surgical side was 95.72 (range 70.1-142) and 100.7 (range 68-161) for the nonoperated side (p<0.001). No patients reported any great toe complaints or symptomatic deficits of flexion strength. No neurovascular or skin complications were encountered.

Conclusion

The current study demonstrated satisfactory and comparable results with minimal complications when utilizing the FHL tendon transfer in acute Achilles tendon ruptures, compared to the currently utilized methods.
Level of evidence: Level II Prospective Cohort Case series study
Key words: Acute achilles rupture; Achilles injury; Achilles tendon tear management; Endoscopic Flexor Hallucis Longus tendon transfer; Achilles tendon management.


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