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  4. Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer.
 
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Titre

Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer.

Type
article
Institution
Externe
Périodique
International Orthopaedics  
Auteur(s)
Wegrzyn, J.
Auteure/Auteur
Luciani, J.F.
Auteure/Auteur
Philippot, R.
Auteure/Auteur
Brunet-Guedj, E.
Auteure/Auteur
Moyen, B.
Auteure/Auteur
Besse, J.L.
Auteure/Auteur
Liens vers les personnes
Wegrzyn, Julien  
ISSN
1432-5195
Statut éditorial
Publié
Date de publication
2010-12
Volume
34
Numéro
8
Première page
1187
Dernière page/numéro d’article
1192
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The purpose of this study was to report the management and outcome of 11 patients presenting with chronic Achilles tendon (AT) rupture treated by a modified flexor hallucis longus (FHL) transfer. Seven patients presented with a neglected AT rupture, one with a chronic AT rupture associated with Achilles tendinosis and three with an AT re-rupture. AT defect after fibrosis debridement averaged 7.4 cm. In addition to FHL transfer, we performed an augmentation using the two remaining fibrous scar stumps of the ruptured AT. Functional assessment was performed using the AOFAS score and isokinetic evaluation was performed to assess ankle plantarflexion torque deficit. Follow-up averaged 79 months. Functional outcome was excellent with a significant improvement of the AOFAS score at latest follow-up. No re-rupture nor major complication, particularly of wound healing, was observed. All patients presented with a loss of active range of motion of the hallux interphalangeal joint without functional weakness during athletic or daily life activities. Isokinetic testing at 30 degrees/second and 120 degrees/second revealed a significant average decrease of 28 ± 11% and 36 ± 4.1%, respectively, in plantarflexion peak torque. Although strength deficit persisted at latest follow-up, functional improvement was significant without morbidity due to FHL harvesting. For patients with chronic AT rupture with a rupture gap of at least 5 cm, surgical repair using FHL transfer with fibrous AT stump reinforcement achieved excellent outcomes.
Sujets

Achilles Tendon/injur...

Achilles Tendon/physi...

Achilles Tendon/surge...

Adult

Aged

Ankle Joint/physiopat...

Ankle Joint/surgery

Biomechanical Phenome...

Chronic Disease

Female

Humans

Male

Middle Aged

Postoperative Complic...

Range of Motion, Arti...

Reconstructive Surgic...

Recovery of Function

Rupture

Tendon Transfer/metho...

Torque

Treatment Outcome

PID Serval
serval:BIB_66487DFEF05D
DOI
10.1007/s00264-009-0859-1
PMID
19697026
WOS
000285222100017
Permalien
https://iris.unil.ch/handle/iris/218206
Date de création
2020-01-17T06:47:58.388Z
Date de création dans IRIS
2025-05-21T04:04:13Z
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