• Vol. 39 No. 1, 58–60
  • 15 January 2010

Chronic Achilles Tendon Rupture Treated with Two Turndown Flaps and Flexor Hallucis Longus Augmentation – Two-year Clinical Outcome



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Introduction: Both conservative and operative management have been described in the literature for the management of chronic Achilles tendon ruptures with surgical management generally having more favourable results. In our institution, the favoured reconstructive technique was the use of 2 turndown tendon flaps fashioned from the proximal Achilles tendon augmented by a teno-myodesis of the flexor hallucis longus. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure.

Materials and Methods: From the records, a total of 9 patients underwent the above-mentioned procedure of whom 6 patients had complete data collection sets [including SF-36, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, ankle range of motion (ROM), presence of residual symptoms and complications] at 2 years of follow-up.

Results: Our results showed an average AOFAS Ankle-Hindfoot score of 94.2, VAS of 0 in all but 1 patient, and generally high scores (75-96) in all 8 domains of the SF-36 questionnaire. Patient satisfaction was also rated to be high from the surgical procedure.

Conclusion: We submit that the procedure adopted at our institution is able to reproduce satisfactory results with low morbidity in patients with this challenging condition.

Chronic Achilles tendon rupture is a disabling condition resulting in ankle pain, weakened ankle plantarflexion and abnormal gait. Management of chronic ruptures is technically challenging with generally poorer outcomes and higher complication rates than that of acute repair. Current literature suggests this problem is still better tackled surgically although no single technique has been shown to be clearly superior.

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