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Tendon split lengthening technique for flexor hallucis longus tendon rupture.

Jae Yong Park1, Chenyu Wang2, Hee Dong Kim2

  • 1Department of Orthopedic Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.

Journal of Orthopaedic Surgery and Research
|November 8, 2017
PubMed
Summary

This study presents a novel technique for flexor hallucis longus (FHL) tendon rupture reconstruction. Split tendon lengthening allows repair of FHL tendon defects without grafts, improving great toe function.

Keywords:
Flexor hallucis longusGreat toeSplit tendon lengtheningTendon defectTendon rupture

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Tendon Repair

Background:

  • Flexor hallucis longus (FHL) tendon rupture can cause great toe clawing if repaired too tightly.
  • Delayed diagnosis of FHL rupture may result in non-opposable tendon ends due to contracture or poor tissue quality.

Purpose of the Study:

  • To describe a technique for reconstructing FHL tendon ruptures with tendon defects.
  • To avoid free tendon grafting in FHL tendon reconstruction.

Main Methods:

  • A split tendon lengthening technique at the midfoot around the knot of Henry was employed.
  • Ankle block anesthesia facilitated active interphalangeal (IP) joint movement to determine optimal tendon length.
  • Five patients with FHL tendon defects distal to the knot of Henry were treated between May 2012 and September 2015.

Main Results:

  • Four out of five patients achieved active plantarflexion of the great toe IP joint.
  • The mean American Orthopedic Foot and Ankle Society (AOFAS) score was 92 at a mean follow-up of 44 months.
  • One patient, operated under spinal anesthesia, could not actively plantarflex but showed no extension deformity.

Conclusions:

  • Split tendon lengthening is an effective method for reconstructing FHL tendon ruptures with defects.
  • This technique allows for FHL tendon defect repair without the need for a free tendon graft.