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Related Experiment Video

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Technique tip: EDL-to-EHL double loop transfer for extensor hallucis longus reconstruction.

Gonzalo F Bastías1, Natalio Cuchacovich2, Adam Schiff3

  • 1Foot and Ankle Unit, Instituto Traumatológico, Santiago, Chile; Department of Orthopedic Surgery, Clínica Indisa, Santiago, Chile; Department of Orthopedic Surgery, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|February 8, 2018
PubMed
Summary

A novel dynamic double loop tendon transfer using the extensor digitorum longus (EDL) of the second toe effectively reconstructs irreparable extensor hallucis longus (EHL) injuries. This safe and reproducible technique restores hallux extension without complications.

Keywords:
Extensor hallucis longusLacerationReconstructionTendon transfer

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Foot and Ankle Surgery

Background:

  • Extensor hallucis longus (EHL) tendon injuries, often from foot lacerations, typically require direct repair or reconstruction.
  • Allograft or autograft reconstruction is used for irreparable cases, but allograft availability is limited globally.
  • Existing tendon transfer methods face challenges like tendon diameter mismatch and reduced resistance.

Purpose of the Study:

  • To present a new dynamic double loop tendon transfer technique for reconstructing non-reparable EHL lacerations.
  • To evaluate the safety, efficacy, and functional outcomes of this novel technique.

Main Methods:

  • A case series involving three patients with non-reparable EHL lacerations.
  • Utilized a dynamic double loop transfer of the extensor digitorum longus (EDL) of the second toe to the EHL tendon.
  • Assessed outcomes at one-year follow-up.

Main Results:

  • All three patients achieved full active and passive hallux extension.
  • Excellent functional outcomes (AOFAS Score) and high patient satisfaction were reported.
  • No reruptures, complications, or second toe deformities were observed.

Conclusions:

  • The second EDL-to-EHL double loop transfer is a safe, reproducible, and cost-effective method for EHL reconstruction when primary repair fails.
  • This technique effectively addresses EHL ruptures without compromising the function of the donor tendon.