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Related Experiment Video

Updated: Apr 11, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
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Neglected TA Rupture Repair by Gastrocnemius Turn-down Flap and Flexor Hallucis Longus Augmentation Using Screws.

Devarshi Rastogi1, Brij Mohan Patel, Mayank Mahendra

  • 1Department of Orthopaedic Surgery, KGMU, Lucknow, Uttar Pradesh, India.

Annals of African Medicine
|April 10, 2026
PubMed
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This study shows that gastrocnemius turn-down flap reconstruction with flexor hallucis longus (FHL) augmentation significantly improves function in chronic Achilles tendon ruptures. This surgical technique offers a viable solution for complex cases, enhancing patient outcomes.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Regenerative Medicine

Background:

  • Chronic Achilles tendon ruptures pose significant reconstructive challenges.
  • Gastrocnemius turn-down flap with flexor hallucis longus (FHL) tendon augmentation is a common surgical approach.
  • Restoring tendon continuity and function in neglected ruptures requires specialized techniques.

Purpose of the Study:

  • To detail the surgical technique for chronic Achilles tendon rupture repair.
  • To evaluate functional outcomes of this repair using calcaneal screw fixation.
  • To assess the efficacy of gastrocnemius turn-down flap with FHL augmentation.

Main Methods:

  • 15 patients with chronic Achilles tendon ruptures underwent the procedure.
  • Gastrocnemius turn-down flap reconstruction with FHL augmentation was performed.
Keywords:
Achilles Tendon Total Rupture ScoreAmerican Orthopaedic Foot and Ankle SocietyRupture chronique du tendon d’Achillecalcaneal screw fixationchronic Achilles tendon rupturefixation par vis calcanéenneflexor hallucis longusfléchisseur de l’hallux longgastrocnemius turn-down flaplambeau gastrocnémienscore AOFASscore ATRS

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  • Calcaneal screw fixation (bioabsorbable or titanium) was utilized.
  • Functional outcomes were measured using AOFAS and ATRS scores preoperatively and at 6, 12 months postoperatively.

    • Main Results:

    • Significant improvements were observed in both AOFAS and ATRS scores post-surgery.
    • AOFAS scores increased from 52.86 to 89.56 at 12 months (P < 0.001).
    • ATRS scores improved from 43.36 to 81.93 at 12 months (P < 0.001).

    Conclusions:

    • Gastrocnemius turn-down flap reconstruction with FHL augmentation provides substantial functional recovery.
    • This technique is effective for treating neglected Achilles tendon ruptures.
    • The surgical approach leads to significant improvements in patient-reported outcomes.