The rupture of the Achilles tendon (AT) usually occurs in high-caliber athletes, but low-demand patients are also are risk, mainly if they are under corticoids or quinolones. The diagnosis of the AT rupture is usually neglected, and this could result in a worse prognosis for the patient if not treated in an appropriate time. For these patients or for those with high surgical risk, an option of minimally invasive surgery remains attractive. Classical techniques consist of direct repair or augmentation with the tendon of the flexor hallucis longus as well as nonanatomical tendon transfers which can generate issues with the donor site. We present a pioneering technique that is analogous to that used for the surgical treatment of distal rupture of the biceps tendon, which consist of a transfer technique of flexor hallucis longus by extracortical fixation interference screw associated to a direct tendon reinsertion performed through a bone tunnel on the superior and posterior aspect of the calcaneus using an extracortical drilling system and an interference screw within the calcaneal tunnel. The arthroscopic approach may be technically challenging, and a high-level of arthroscopic skills are required to complete the procedure but after a learning curve it represents a feasible a safe technique. Levels of Evidence:Therapeutic, Level IX: Evidence from opinion of authorities and/or reports of expert committee

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Background: Distal first metatarsal osteotomy is used to correct mild or moderate Hallux Valgus (HV), and multiple surgical techniques have been described. Percutaneous surgery for HV uses small skin incisions to correct the forefoot deformity, and shorter recovery times and fewer complications have been reported. Distal first metatarsal osteotomy is used for the correction of mild or moderate HV, and multiple surgical techniques have been described. We designed a cadaveric study to compare the resistance to axial load between two distal first metatarsal osteotomies, SERI and percutaneous chevron, both of which are non-fixated techniques. The first aim of this study was to develop a systematic technique for measuring the sagittal displacement on lateral foot X-ray. Our second objective was to measure the resistance to axial load in both these osteotomies. Methods: Ten pairs of freshly frozen cadaveric feet were randomly assigned to one of the two techniques investigated. Pre- and post-operative X-rays were obtained. After surgery, the feet were placed under progressive axial loads up to 60 kg. Joint angles and bone distances were measured and differences between the two techniques were statistically assessed. Results: SERI osteotomy gave a significantly higher plantar displacement when the axial load was under 30 kg. From over 30 kg there were no significant differences between the two techniques. Metatarsal head displacement under axial load was less variable with chevron osteotomy. Plantar angulation was increased in both techniques. Conclusions: Although the chevron technique confers higher stability regarding fragment displacement during axial loading, both techniques increase the plantar angulation of the metatarsal head. Level of Evidence Cadaveric study. Level V.

Background Distal first metatarsal osteotomy is used to correct mild or moderate hallux valgus (HV). We designed a cadaveric study to compare the resistance to axial load between two percutaneous distal first metatarsal osteotomies: Bösch osteotomy and percutaneous chevron. The first aim of this study was to develop a systematic technique for measuring the sagittal displacement on lateral foot X-rays. Our second objective was to measure the resistance to axial load for both of these osteotomies. Methods Ten pairs of freshly frozen cadaveric feet were randomly assigned to one of the two techniques investigated. Pre- and post-operative lateral X-rays were obtained. After surgery, the feet were placed under progressive axial loads up to 60 kg. Metaphyseo-diaphyseal angle (MDA) and the distance between bone fragments were measured, and the differences between the two techniques were statistically assessed. Results The MDA decreased in both surgical techniques. The mean plantar tilt was −6.90 degrees (SD = 10.251) for chevron osteotomy and −5.34 degrees (SD = 16.621) for Bösch osteotomy. There was no significant difference between the techniques (p = 0.41). Regarding the distance between the bone fragments, the Bösch osteotomy produced more plantar displacement than the chevron osteotomy, which was statistically significant for the 10 and 20 kg loads (p = 0.031 and 0.04, respectively). At loads ≥ 30 kg, the bone fragment distance did not differ significantly between the techniques (p = 0.114). Conclusions Although the chevron technique confers higher stability regarding fragment displacement during axial loading, both techniques increase the plantar angulation of the metatarsal head. Level of evidence Cadaveric study. Level V.