Hypertrophy of the flexor hallucis longus muscle after tendon transfer in patients with chronic Achilles tendon rupture

Oksanen, Maria Mikaela; Haapasalo, Heidi; Elo, Petra; Laine, Heikki-Jussi

doi:10.1016/j.fas.2014.06.003

Cited by 38 publications

(35 citation statements)

References 20 publications

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“…Yeoman et al [15] treated 11 patients with chronic Achilles tendon rupture using FHL technique and interference screw fixation, showing reliable outcomes and low complication morbidity. Oksanen et al [28] reported that mean hypertrophy of 52% of the FHL muscle was observed by MRI after FHL. Similar phenomenon was also observed in the current study.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Strategy for the Chronic Achilles Tendon Rupture

Lin

Yang

Yin

et al. 2016

BioMed Research International

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Background. Chronic Achilles tendon rupture is usually misdiagnosed and treated improperly. This study aims to better understand the treatment of chronic Achilles tendon rupture. Methods. Patients who were not able to perform a single-limb heel rise were chosen. Pre- and postoperative magnetic resonance imaging (MRI) were conducted. By evaluating the presence or absence of Achilles tendon stumps and the gap length of rupture, V-Y advancement, gastrocnemius fascial turndown flap, or flexor halluces longus tendon transfer were selected for tendon repair. The function of ankle and foot was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores and Achilles Tendon Total Rupture Score (ATRS). Results. Twenty-nine patients were followed up. One patient had superficial incision infection, which was healed after debridement and oral antibiotics. Three months postoperatively, MRI showed some signs of inflammation, which disappeared at one or two years postoperatively. All patients were able to perform a single-limb heel rise. Mean AOFAS scores and ATRS scores were increased at the latest follow-up. Conclusion. Surgical options can be determined by evaluating the presence of the Achilles tendon stumps and the gap length, which can avoid using the nearby tendon and yield satisfactory functional results.

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Section: Discussionmentioning

confidence: 99%

“…Similar phenomenon was also observed in the current study. This may demonstrate that the FHL had good adaptation capacity [28]. Coull et al [29] found that though the active range of motion of interphalangeal joint might bet lost, it did not impair functions such as walking, running, and stair climbing.…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy for the Chronic Achilles Tendon Rupture

Lin

Yang

Yin

et al. 2016

BioMed Research International

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“…However, in patients where this feature is not of paramount importance, FHL transfer can be used with excellent results. 53,54 If the gap is greater than 6 cm despite maximal plantar flexion of the ankle and traction on the tendon stumps, peroneus brevis is not sufficient to fill the gap and ipsilateral hamstring tendon graft is indicated. 55 …”

Section: Management Of Chronic Achilles Tendon Rupturementioning

confidence: 99%

Chronic Achilles Tendon Disorders

Maffulli¹,

Via²,

Oliva³

2015

Clinics in Sports Medicine

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“…(14) Evidence demonstrated a hypertrophy of the FHL after performing a tendon transfer. (15,16) In our practice, there was a clinical observation that the FHL hypertrophy may even occur preoperatively in cases with severe Achilles tendinopathy as a compensatory mechanism. The purpose of the current study was to nd out whether such an observation is true or not.…”

Section: Introductionmentioning

confidence: 99%

Flexor Hallucis Longus Hypertrophy Secondary to Achilles Tendon Tendinopathy: An MRI-based Case-Control Study

Wirth

Andronic

Aregger

et al. 2020

Preprint

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Background: The purpose of this study was to outline indirect signs of advanced Achilles tendinopathy on magnetic resonance imaging (MRI) and develop a potential tool that could aid in surgical decision-making.Methods: Magnetic resonance imaging (MRI) scans of Achilles tendon were analyzed retrospectively in two consecutive cohorts. Control group consisted of patients that had an MRI due to other reasons and no signs of tendinopathy. Two parameters from two muscle bellies were measured and compared on axial MRI scans 4 to 5 cm above the ankle joint line at the level of greatest thickness: area and diameter of the triceps surae (TS) and of the flexor hallucis longus (FHL). Interobserver agreement was analyzed. A receiver operating characteristic (ROC) curve was created for both quotients to assess potential cut-off points.Results: A total of 60 patients for each study group were included. The ratios for area and for diameter showed significant higher values for FHL in the tendinopathy group (p<0.001). There was strong to very strong interobserver agreement (rho=0.744). A diameter ratio FHL/TS of 2.0 or higher had a sensitivity of 49% and specificity of 90% for concomitant Achilles tendinopathy.Conclusion: In our patient cohort, flexor hallucis longus hypertrophy was observed even before a tendon transfer was employed as a possible compensatory mechanism for Achilles tendon tendinopathy. Using the tool described in this study, measuring a value of 2.0 or higher on an axial MRI, may be indicative as an indirect sign of functional deterioration of the Achilles tendon.

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Hypertrophy of the flexor hallucis longus muscle after tendon transfer in patients with chronic Achilles tendon rupture

Cited by 38 publications

References 20 publications

Surgical Strategy for the Chronic Achilles Tendon Rupture

Surgical Strategy for the Chronic Achilles Tendon Rupture

Chronic Achilles Tendon Disorders

Flexor Hallucis Longus Hypertrophy Secondary to Achilles Tendon Tendinopathy: An MRI-based Case-Control Study

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