Treatment of chronic Achilles tendon disorders with flexor hallucis longustendon transfer/augmentation

Chronic disorders of the Achilles tendon are commonly seen by the orthopaed ic surgeon. In cases that are resistant to conservative treatment, a variet y of surgical procedures have been utilized in the past. The indications fo r a previously described technique of flexor hallucis longus tendon transfe r for reconstruction of chronic Achilles tendon rupture have been expanded to include further subsets of chronic Achilles tendinopathy, including rupt ure and tendinosis. We evaluated 20 patients (mean age 61) who underwent fl exor hallucis longus transfer for treatment of chronic Achilles tendinopath y at a mean of 14 months following surgery. Our results were measured with the SF-36 survey, AOFAS Ankle-Hindfoot Scale, and Cybex strength and range of motion testing. Wound complications, tip-toe stance, and calf circumfere nce were also assessed. There were no postoperative reruptures, tendinopath y recurrences, or wound complications. Despite a small loss of calf circumf erence, range of motion, and plantarflexion strength, 90% of patients score d 70 or higher on the AOFAS scale. SF-36 testing revealed significantly tow er scores in the physical function category when compared with United State s norms. Flexor hallucis longus tendon transfer/augmentation is a reasonabl e option for treatment of chronic Achilles tendinosis and rupture.