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Updated: Jun 29, 2026

Murine Flexor Tendon Injury and Repair Surgery
Published on: September 19, 2016
Affordable approach using flexor hallucis longus muscle graft for chronic Achilles tendon rupture: A case report
Romy Deviandri1, Muhammad Wiranata2, Richardo Winara2
1Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Faculty of Medicine, Universitas Riau, Arifin Achmad Hospital, Pekanbaru, Indonesia.
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.

