ACTA FAC MED NAISS 2020;37(3):302-309|
ACTA FAC MED NAISS 2020;37(3):302-309 |
Case report
UDC: 616.74-007.43-089
DOI: 10.5937/afmnai2003302M
Chronic Partial Rupture of the Achilles Tendon - the
Flexor Hallucis Longus (FHL) Tendon Transfer: A Report of Two Cases
Mihajlo Mitrović1,
Dražen Jelača1, Ivana Mitrović2
SUMMARY
Achilles tendon injuries most commonly occur in athletes, but also in the
middle-aged population practicing recreational sports. The aetiology of injury
and disease of the Achilles tendon has not been completely clarified. While
acute injury can be attributed to trauma, research showed that a chronic
degenerative process is present in most ruptures. While there are still a lot of
dilemmas when it comes to treating acute rupture, chronic rupture and disease
are predominantly treated operatively. Many operative procedures can be used
when treating chronic Achilles tendon diseases, such as excision of degenerative
changes and tendon decompression, reconstruction using fascia lata and VY
plastics, tendon transfer (Flexor Hallucis Longus – FHL, Flexor Digitorum Longus
– FDL, Peroneus Brevis – PB) and allograft and synthetic graft reconstruction.
The objective of the paper was to present the results of treating chronic
partial Achilles tendon rupture by scar excision and FHL tendon transposition.
The patients were one professional and one recreational athlete, both of whom
were treated nonoperatively for a long time. They were both tested using AOFAS
and ATRS tests preoperatively and postoperatively. The results showed a
significant improvement of function and both patients were able to return to
their usual activities. Postoperative results of AOFAS and ATRS tests were
almost identical to the result on the uninjured leg. Our little series, as well
as a lot of research performed by other authors, shows that an FHL tendon
transposition is a safe and efficient method in treating diseases and injuries
of the Achilles tendon.
Key words:
Achilles tendon, FHL tendon, transposition, partial rupture