Affordable approach using flexor hallucis longus muscle graft for chronic Achilles tendon rupture: A case report

  • 1Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Faculty of Medicine, Universitas Riau, Arifin Achmad Hospital, Pekanbaru, Indonesia. Electronic address: r.deviandri@umcg.nl.
  • 2Faculty of Medicine, Universitas Riau, Arifin Achmad Hospital, Pekanbaru, Indonesia.
  • 3Department of Orthopedics, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.

Abstract

INTRODUCTION AND IMPORTANCE

The Achilles tendon is vital in maintaining balance when walking. An affordable approach using the flexor hallucis longus (FHL) tendon graft is a cost-effective treatment.

CASE PRESENTATION

A 35-year-old male who worked as a porter was taken to the clinic after falling while going downstairs a year ago. The physical examination showed gastrocnemius muscle atrophy and limited range of motion (ROM). The Thompson test was performed, and the result was positive for the Achilles tendon rupture (ATR).

CLINICAL DISCUSSION

Various techniques could be used in a chronic Achilles case, including autograft and allograft. Because the gap was 5.5 cm, we implemented a suitable surgical approach using an FHL tendon graft to repair a chronic ATR. The Euroqol 5-Dimension (EQ5D), the Visual Analog Scale (VAS), the Foot and Ankle Disability Index (FADI), and the cost-effectiveness (CEA) were measured to follow up patients' outcomes.

CONCLUSION

A grafting procedure using the FHL tendon was affordable and cost-effective for reconstructing a chronic ATR. This technique was preferable, especially in remote area hospitals.

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