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Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Flexor hallux tendon transfer: comparative study through double or single approach
Marcos Hideyo Sakaki1, Alexandre Leme Godoy-Santos1, Rafael Trevisan Ortiz1
11. Institute of Orthopedics and e Traumatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil, 1. Institute of Orthopedics and e Traumatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil, Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Institute of Orthopedics and e Traumatology, São Paulo, SP, Brazil.
The double combined approach for harvesting the flexor hallucis longus (FHL) tendon graft provides a significant 42.43 mm length gain. This method offers a valuable increase in graft length compared to the single approach.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Surgical Techniques
Background:
- The flexor hallucis longus (FHL) tendon is a crucial graft source in foot and ankle reconstruction.
- Optimizing FHL graft length is essential for successful surgical outcomes.
- Current harvesting techniques may limit the available graft length.
Purpose of the Study:
- To quantitatively compare the graft length obtained using a single surgical approach versus a double combined approach for FHL tendon harvesting.
- To determine if the double combined approach offers a significant increase in FHL graft length.
Main Methods:
- The study utilized 16 fresh cadavers (32 feet) to measure FHL graft length.
- A posteromedial ankle incision and a plantar cavus incision were employed for the double combined approach.
- Measurements were taken with cadavers in ventral decubitus.
Main Results:
- The average gain in tendon length (GTL) was 42.43 mm (range: 32-48 mm).
- No statistically significant differences in GTL were observed between the right and left sides (p=0.463).
- Linear regression analysis showed no significant differences in GTL based on sample height (p=0.38311 and p=0.82640).
Conclusions:
- Harvesting the FHL graft using a double combined approach yields an average length gain of 42.43 mm.
- This technique provides a greater tendon length compared to a single harvesting approach.
- The double combined approach is a viable method for maximizing FHL graft length in reconstructive surgery.
