Peroneus brevis tendon transfer with the use of an interference screw in Achilles tendon injuries

Abstract

Objective: To perform a functional evaluation of peroneus brevis tendon transfer using an interference screw fixation in chronic Achilles tendon injuries. Methods: This was a cross-sectional, retrospective and observational study with medical record reviews and a convenience sample of ten (10) patients who underwent surgery between January 2013 and June 2017. The following clinical aspects were evaluated: sex, age group, race, affected side, injury time, distal stump size, gap between stumps, AOFAS questionnaire (pre- and 3 and 6 months postoperatively), patient satisfaction with treatment and complications. Results: The mean subject age was 38.1 years; subjects were predominantly male (80%), and with respect to laterality, the right side was predominant. The paratendinous posterolateral incision technique was used, with the identification and use of the peroneus brevis associated with bone tunnel fixation onto the Achilles using an interference screw. Surgical planning of the technique followed the same procedure in all cases. Two complications occurred during evolution when considering the early and late postoperative periods. Conclusion: The treatment of Achilles tendon injuries with this technique proved to be a good option for chronic injuries with satisfactory results in terms of maintenance of functionality and patient satisfaction postoperatively. Level of Evidence III; Prognostic Studies; Retrospective Study.

Insertional Achilles tendinopathy

“…It causes significant disability across a very wide range of age groups (3) . Frequently seen in foot and ankle outpatient clinics, it behaves like a severe disability, and is common in female patients, who can no longer wear ordinary women's shoes (4) .…”

“…Several surgical techniques can be found in the literature. In our department, we prefer the technique consisting of distal resection of the calcaneal tendon, posterior exostectomy (when Haglund's deformity is present), lengthening of the myotendinous junction, using a modified Vulpius procedure (3) , and reinsertion of the distal stump in the posterior calcaneal tuberosity after debridement of all soft tissue around the posterolateral and medial aspect of the calcaneus, using two 5mm anchors for reinsertion of the healthy stump of the calcaneal tendon (4) . J Foot Ankle.…”