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Updated: Jun 20, 2026
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Flexor hallucis longus tendon transfer for reconstruction of chronically ruptured Achilles tendons
Ravindra H Mahajan1, Rakesh B Dalal
1Department Of Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, United Kingdom. drtanu_mhas@hotmail.com
Purpose:
To report the mid-term results of flexor hallucis longus (FHL) tendon transfer for reconstruction of chronically ruptured Achilles tendons.
Methods:
24 men and 12 women aged 56 to 78 (mean, 70) years underwent FHL tendon transfer for reconstruction of chronically ruptured Achilles tendons by a single surgeon. Ruptures were secondary to trauma (n=20), long-term steroid intake (n=12), or chronic renal failure (n=6). Two patients had bilateral ruptures. The mean interval from rupture to surgery was 15 (range, 12-24) weeks. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores were compared. Wound healing, push-off, and patient satisfaction were evaluated.
Results:
The mean follow-up period was one year. The mean AOFAS scores were 69 (range, 58-76) preoperatively and 88 (range, 79-94) postoperatively; the mean improvement was 19 (p<0.001). 28 patients had excellent and 8 had fair results. 33 patients graded their outcome as 'very satisfactory' and 3 as 'satisfactory'. Five patients developed wound healing complications but only one needed debridement. There was no fixation-related complication or sural nerve injury.
Conclusions:
Transfer of the FHL for reconstruction of chronically ruptured Achilles tendons is effective, safe and easily performed in patients with low-to-moderate demands.
