Arthroscopic Flexor Hallucis Longus Transfer for Chronic Achilles Tendon Rupture

Achilles tendon rupture using FHL tendon transfer endoscopically

“…This article introduces the technique and early experience of endoscopic treatment of FHL in CATR. Similar techniques have been described by Goncalves et al Hong et al, 4 and Gossage et al 5 in 1, 4 and 2 patients, respectively. No other publication describes the endoscopic technique of FHL transfer CATR.…”

Endoscopic Transfer of Flexor Hallucis Longus Tendon for Chronic Achilles Tendon Rupture: Technical Aspects and Short-Time Experiences

“…Rahm et al 6 reported infection or wound healing problems in 7 out of 42 patients (17%). The 6 patients we operated upon with the endoscopic FHL transfer, had no infection and no wound healing problems, neither had the 4 patients described by Hong et al, 14 who used a similar endoscopic technique for FHL transfer. The results after endoscopic FHL transfer are promising with regard to the soft tissue complications, though, the total number of patients described by us and in published articles by Hong et al, 13 Gonçalves et al, 14 and Gossage et al 15 is low.…”

“…To avoid tenting of the tendon, the crural fascia is divided approximately 5 cm following the FHL proximally. This is not described by Hong et al, 13 Gonçalves et al, 14 or Gossage et al 15 For better plantar flexion power, the calcaneal bone tunnel is to be placed far posterior and close to the Achilles tendon to increase the weight arm. 25 Arastu et al 25 demonstrated in a computer program study that the posterior positioning of the FHL tendon on the tuber calcanei increases the power, but decreases the ankle range of motion.…”

“…Nerve affection is not mentioned in previous reports after endoscopic FHL transfer. 13-15 Herbst et al 24 reported damage to the medial plantar nerve when using the 2-incision technique. Monroe et al 8 reported initial partial sensory loss in 3 out of 7 patients using the 2-incision technique.…”

“…The technique for endoscopic FHL repair for CATR and early experiences with this technique are presented. A similar technique was previously described by Gonçalves et al, 13 Hong et al, 14 and Gossage et al, 15 presenting, respectively, 1, 4, and 2 patients. No other publications describe the endoscopic technique for FHL transfer for CATR.…”