208 results match your criteria Ankle Flexor Hallucis Longus Tendon Injuries


Anatomical Study of Minimally Invasive Lateral Release Techniques for Hallux Valgus Treatment.

Foot Ankle Int 2020 May 26:1071100720920863. Epub 2020 May 26.

Human Anatomy Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

Background: Lateral release (LR) for the treatment of hallux valgus is a routinely performed technique, either by means of open or minimally invasive (MI) surgery. Despite this, there is no available evidence of the efficacy and safety of MI lateral release. Our aim was to study 2 popular techniques for MI LR in cadavers by subsequently dissecting the released anatomical structures. Read More

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http://dx.doi.org/10.1177/1071100720920863DOI Listing

Flexor Hallucis Longus Tendon Single-Incision Transfer Stabilized With Autologous Bone Fixation.

J Foot Ankle Surg 2020 Jan - Feb;59(1):213-215

Consultant Orthopaedic Surgeon, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, United Kingdom.

Flexor hallucis longus transfer is routinely used as a technique to salvage a chronic or neglected Achilles tendon rupture. The single-incision (or short harvest) technique provides adequate graft suitable for fixation with interference screws. We have used a bore corer instead of a drill to establish the tendon tunnel and at the same time use the harvested autograft for interference fit and avoid the use of screws, providing what we consider to be a more biologic form of fixation. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.07.011DOI Listing

Gouty Achilles Tendinopathy: A Case Report.

J Am Podiatr Med Assoc 2019 Jul;109(4):327-333

Tendinopathy in the presence of gouty arthropathy is relatively common, yet the clinical suspicion for gout involvement in acute tendon pain remains low. A 49-year-old man presented with an acute, tender, erythematous mass to the right posterior heel. A computed tomographic scan was obtained, which revealed a septated fluid collection superficial to the Achilles tendon. Read More

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http://dx.doi.org/10.7547/18-129DOI Listing

Neglected Iatrogenic Flexor Hallucis Longus Tendon Rupture After Haglund's Endoscopic Surgery: A Case Report.

J Foot Ankle Surg 2020 Jan - Feb;59(1):169-172. Epub 2019 Nov 19.

Professor, Chairman, Orthopaedic Department, Swiss Ortho Center, Schmerzklinik Basel, Swiss Medical Network, Basel, Switzerland. Electronic address:

Rupture of the flexor hallucis longus (FHL) tendon is a rare condition that can occur with direct or indirect trauma; most of the injuries are complete ruptures resulting from laceration. Endoscopic calcaneoplasty is used for treatment of symptomatic Haglund's deformity, and complications of this procedure are rare. Iatrogenic FHL tendon rupture occurring after endoscopic calcaneoplasty has not been reported previously. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.07.009DOI Listing

Endoscopic Flexor Hallucis Longus Tendon Transfer for Reconstruction of the Achilles Tendon Rupture in High-Risk Patients: A Case Series.

Authors:
Jake I Lee

J Foot Ankle Surg 2019 Nov;58(6):1257-1261

Senior Physician, Department of Orthopedic Surgery, Kaiser Foundation Hospital, Redwood City, CA. Electronic address:

The neglected Achilles tendon rupture requires surgical reconstruction for the best functional outcome. According to the current literature, there are many reconstructive options available that demonstrate acceptable functional results in most cases. These procedures require large incisions, leading to potential wound-healing complications. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.04.014DOI Listing
November 2019

Minimally Invasive and Endoscopic Treatment of Haglund Syndrome.

Foot Ankle Clin 2019 Sep 18;24(3):515-531. Epub 2019 May 18.

Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR 999077, China.

Haglund syndrome is a triad of posterosuperior calcaneal prominence (Haglund deformity), retrocalcaneal bursitis, and insertional Achilles tendinopathy. The sources of pain include the posterior calcaneal wall cartilage, retrocalcaneal and subcutaneous adventitial bursa, and the Achilles tendon. Resection of the posterosuperior calcaneal tubercle, bursectomy, excision of the Achilles tendon pathology, reattachment of the Achilles tendon, gastrocnemius aponeurotic recession, and flexor hallucis longus transfer have been proposed as surgical treatment options. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10837515193004
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http://dx.doi.org/10.1016/j.fcl.2019.04.006DOI Listing
September 2019
8 Reads

Endoscopic Management of Chronic Achilles Tendon Rupture.

Foot Ankle Clin 2019 Sep 13;24(3):459-470. Epub 2019 Jun 13.

University Hospital Llandough (UHL), Penlan Road, Llandough, CF64 2XX, UK.

Chronic ruptures of the Achilles tendon are often missed injuries, which is challenging for the surgeon. The complications from reconstruction are a considerable concern. Primary repair may be attempted, but the missed injury often presents later than 4 weeks with gaps greater than 4 cm, necessitating more complex reconstructions using local tissues such as turn-down flaps and VY plasty, requiring large incisions in an unfavorable area of the body. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.04.010DOI Listing
September 2019
2 Reads
0.844 Impact Factor

Reconstruction of chronic achilles tendon ruptures in elderly patients, with vascularized flexor hallucis longus tendon transfer using single incision technique.

Acta Orthop Belg 2019 Mar;85(1):137-143

The purpose is to report the outcome following reconstruction of neglected Achilles tendon ruptures in elderly patients with Flexor hallucis longus tendon (FHL) biotenodesis. Seventeen cases (mean age 65.7 years), of Achilles tendon reconstruction with FHL biotenodesis for chronic ruptures were reviewed. Read More

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March 2019
11 Reads

Achilles Tendon Reconstruction With Bone Block Allograft:Long-Term Follow-Up of Two Cases.

J Foot Ankle Surg 2019 Jul 20;58(4):779-784. Epub 2019 Apr 20.

Faculty, Grant Medical Center, Columbus, OH.

The treatment of neglected or chronically ruptured Achilles tendon is challenging. Various treatments for large defects associated with chronic Achilles ruptures have been described. Many surgeons recommend the use of a tendon transfer, turndown rotational flap, advancement flap, or reconstruction with Achilles tendon allograft with calcaneal bone block. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10672516183051
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http://dx.doi.org/10.1053/j.jfas.2018.11.023DOI Listing
July 2019
13 Reads

[Reconstruction of neglected Achilles tendon rupture: flexor hallucis longus transfer versus gastrocnemius turn-down flaps].

Zhonghua Yi Xue Za Zhi 2019 Feb;99(7):542-546

Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China.

To compare the outcome of either flexor hallucis longus transfer or turn-down of proximal Achilles tendon tissue repair in treating chronic Achilles tendon rupture. The clinical data of 21 patients who underwent repair of Myerson type Ⅲ chronic Achilles tendon rupture at Peking University Sports Medicine Research Institute from May 2012 to March 2015 were retrospectively analyzed. Among them, 11 cases were treated with flexor hallucis longus (FHL) transfer, and 10 cases were treated with gastrocnemius turn-down flaps repair. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2019.07.013DOI Listing
February 2019
10 Reads

Anatomic lectures on structures at risk prior to cadaveric courses reduce injury to the superficial peroneal nerve, the commonest complication in ankle arthroscopy.

Knee Surg Sports Traumatol Arthrosc 2020 Jan 7;28(1):79-85. Epub 2019 Feb 7.

Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.

Purpose: To assess the effectiveness of cadaveric ankle arthroscopy courses in reducing iatrogenic injuries.

Methods: A total of 60 novice surgeons enrolled in a basic cadaveric ankle arthroscopy course were divided into two groups. Group A (n = 32) was lectured on portal placement and use of the arthroscope, whereas group B (n = 28) was in addition lectured on specific portal-related complications. Read More

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http://link.springer.com/10.1007/s00167-019-05373-x
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http://dx.doi.org/10.1007/s00167-019-05373-xDOI Listing
January 2020
31 Reads

Calcific Insertional Achilles Tendinopathy-Achilles Repair With Flexor Hallucis Longus Tendon Transfer: Case Series and Surgical Technique.

J Foot Ankle Surg 2019 Mar 3;58(2):236-242. Epub 2019 Jan 3.

Director of Residency Training, Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Calcific insertional Achilles tendinopathy (CIAT) is a relatively common musculoskeletal entity that results in significant pain and disability, as well as posterior muscle group weakness. There is a lack of evidence criteria to support the timing of operative intervention, choice of procedures, or whether equinus requires treatment. The purpose of this study was to retrospectively review 45 patients (48 feet) who have undergone surgical management of CIAT with concomitant posterior muscle group weakness with the single heel rise testing. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10672516183036
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http://dx.doi.org/10.1053/j.jfas.2018.08.021DOI Listing
March 2019
12 Reads

Flexor hallucis longus tendon transfer for chronic Achilles tendon rupture. A retrospective study.

Foot Ankle Surg 2019 Oct 18;25(5):630-635. Epub 2018 Jul 18.

Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.

Background: The transfer of Flexor Hallucis Longus Tendon (FHL) is an established method for the treatment of chronic Achilles tendon ruptures. An extensive examination of power, strength, endurance and complications related to this procedure is presented.

Methods: 21 patients treated with open FHL transfer for chronic Achilles tendon rupture were studied retrospectively. Read More

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http://dx.doi.org/10.1016/j.fas.2018.07.002DOI Listing
October 2019
3 Reads

Dual Purpose Use of Flexor Hallucis Longus Tendon for Management of Chronic Achilles Tendon Ruptures.

Foot Ankle Spec 2019 Aug 11;12(4):345-349. Epub 2018 Oct 11.

Department of Orthopaedic Surgery and Rehabilitation, Rebecca Sealy Hospital, University of Texas Medical Branch, Galveston, Texas (MAK, MI, VKP).

Chronic Achilles tendon ruptures are uncommon and increase long-term morbidity when untreated. There is no standard treatment for this condition. Chronic Achilles tendon rupture was repaired in 10 patients by harvesting the flexor hallucis longus tendon (FHL) using a minimally invasive technique. Read More

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http://journals.sagepub.com/doi/10.1177/1938640018803695
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http://dx.doi.org/10.1177/1938640018803695DOI Listing
August 2019
4 Reads

Endoscopic Flexor Hallucis Longus Transfer for Chronic Noninsertional Achilles Tendon Rupture.

Foot Ankle Int 2018 Dec 19;39(12):1464-1472. Epub 2018 Aug 19.

1 Human Anatomy and Embriology Unit, University of Barcelona, Barcelona, Spain.

Background:: Operative management of chronic Achilles tendon ruptures is challenging, and numerous techniques have been described. Risk of infection and wound breakdown have been described after open techniques, and minimally invasive methods have been proposed to avoid them. The aim of this study was to describe the clinical and radiological results obtained after endoscopic flexor hallucis longus (FHL) tendon transfer in patients with chronic Achilles tendon rupture. Read More

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http://dx.doi.org/10.1177/1071100718793172DOI Listing
December 2018
12 Reads

The Epidemiology of Ankle Injuries Identified at the National Football League Combine, 2009-2015.

Orthop J Sports Med 2018 Jul 18;6(7):2325967118786227. Epub 2018 Jul 18.

The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado, USA.

Background: American football is a leading cause of sports-related injuries, with the knee, ankle, and shoulder most commonly involved.

Purpose/hypothesis: The purpose of this study was to describe the epidemiology, characteristics, and imaging findings of ankle injuries in football players at the National Football League (NFL) Combine and determine the relationship to player position. We hypothesized that there would be a high relative incidence of ankle injuries in these players compared with other sports and that there would be a direct correlation between the incidence of ankle injuries and player position. Read More

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http://dx.doi.org/10.1177/2325967118786227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052500PMC
July 2018
28 Reads

Reconstruction of Neglected Flexor Hallucis Longus Tendon Rupture: A Case Report.

J Foot Ankle Surg 2018 Nov - Dec;57(6):1256-1258. Epub 2018 Jun 21.

Professor, Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Isolated rupture of the flexor hallucis longus tendon is an unusual injury. We present the case of a neglected flexor hallucis longus tendon closed traumatic rupture at the plantar aspect of the first phalangeal head of the great toe in a middle-age male. The injury occurred while he was dancing. Read More

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http://dx.doi.org/10.1053/j.jfas.2018.03.041DOI Listing
February 2019
5 Reads

Anatomic Basis for Minimally Invasive Flexor Hallucis Longus Transfer in Chronic Achilles Tendon Rupture.

J Foot Ankle Surg 2018 Sep - Oct;57(5):938-941. Epub 2018 Jun 8.

Consultant, OrthoSports-Clinic for Orthopedic Surgery and Sports Medicine, Mt. Elizabeth Novena Specialist Centre, Singapore.

The present cadaveric study was designed to measure the flexor hallucis longus (FHL) tendon length and obtain anatomic data regarding the graft-to-tunnel length ratio in an interference screw fixation model for the FHL short-harvest single-incision technique to the calcaneus. Ten fresh-frozen paired cadaveric specimens were used for the FHL short-harvest technique. The length of the osseous tunnel in the calcaneus was measured. Read More

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http://dx.doi.org/10.1053/j.jfas.2018.03.013DOI Listing
January 2019
18 Reads

Lipidus migrans-a radiology imaging feature after ankle injury.

Skeletal Radiol 2018 Dec 21;47(12):1709-1715. Epub 2018 May 21.

Institute of Radiology, Kantonsspital Baden, Baden, Switzerland.

We present an uncommon imaging feature with fluid fat tracking within the tendon sheath of the flexor hallucis longus (FHL) after traumatic injury to the ankle joint. We propose a coined medical term "lipidus migrans" to define the presence of floating fat in a tendon sheath. This is due to lipohemarthrosis from intra-articular fracture of the ankle with leakage of fluid fat into the tendon sheath. Read More

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http://dx.doi.org/10.1007/s00256-018-2973-xDOI Listing
December 2018
33 Reads

Short-Term Results of Flexor Hallucis Longus Transfer in Delayed and Neglected Achilles Tendon Repair.

J Foot Ankle Surg 2018 Sep - Oct;57(5):1042-1047. Epub 2018 May 18.

Professor, Department of Physiotherapy and Rehabilitation, Private Guven Hospital, Ankara, Turkey.

Flexor hallucis longus (FHL) tendon transfer to the calcaneus in the repair of delayed or neglected Achilles tendon (AT) injuries is a viable and dynamic option. Nineteen patients (18 males, 1 female; mean age 47.4 ± 12. Read More

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http://dx.doi.org/10.1053/j.jfas.2018.03.005DOI Listing
January 2019
32 Reads

Clinical and radiological outcome of Gustilo type III open distal tibial and tibial shaft fractures after staged treatment with posterolateral minimally invasive plate osteosynthesis (MIPO) technique.

Arch Orthop Trauma Surg 2018 Aug 10;138(8):1097-1102. Epub 2018 May 10.

Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, 201700, People's Republic of China.

Objectives: To evaluate the methods and the outcomes of Gustilo type III open distal tibial and tibial shaft fractures with severe anterior and medial soft-tissue injuries, treated with posterolateral minimally invasive plate osteosynthesis (MIPO) technique.

Methods: From May 2015 to May 2016, 10 patients with Gustilo type III open distal tibial and tibial shaft fractures with severe anterior and medial soft-tissue injuries (Gustilo-Anderson classification IIIA, 6; IIIB, 4) were treated with staged protocol using posterolateral minimally invasive plate osteosynthesis (MIPO) technique. The initial wound lavage, debridement, and application of a spanning external fixator were performed within 24 h and the mean interval from injury to definitive surgical treatment was 12. Read More

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http://dx.doi.org/10.1007/s00402-018-2950-9DOI Listing
August 2018
12 Reads

The functional and dynamometer-tested results of transtendinous flexor hallucis longus transfer for neglected ruptures of the Achilles tendon at six years' follow-up.

Bone Joint J 2018 05;100-B(5):584-589

Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.

Aims: Flexor hallucis longus (FHL) tendon transfer is a well-recognized technique in the treatment of the neglected tendo Achillis (TA) rupture.

Patients And Methods: We report a retrospective review of 20/32 patients who had undergone transtendinous FHL transfer between 2003 and 2011 for chronic TA rupture. Their mean age at the time of surgery was 53 years (22 to 83). Read More

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http://dx.doi.org/10.1302/0301-620X.100B5.BJJ-2017-1053.R1DOI Listing
May 2018
3 Reads

Anatomical feasibility study of flexor hallucis longus transfer in treatment of Achilles tendon and posteromedial portal of ankle arthroscopy.

Surg Radiol Anat 2018 Sep 16;40(9):1031-1038. Epub 2018 Apr 16.

Department of Orthopaedic Surgery, Pennsylvania Hospital, University of Pennsylvania School of Medicine, Philadelphia, USA.

Purpose: The aim of this study was to evaluate the occurrence of anatomical variations of the musculotendinous junction of the flexor hallucis longus (FHL) muscle, the relationship between FHL tendon or muscle and the tibial neurovascular bundle at the level of the posterior ankle joint in human cadavers.

Methods: Seventy embalmed feet from 20 male and 15 female cadavers, the cadavers' mean age was 65.4 (range from 14 to 82) years, were dissected and anatomically classified to observe FHL muscle morphology define the relationship between FHL tendon or muscle and the tibial neurovascular bundle. Read More

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http://link.springer.com/10.1007/s00276-018-2021-5
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http://dx.doi.org/10.1007/s00276-018-2021-5DOI Listing
September 2018
17 Reads

Results of Treatment of Posterior Ankle Impingement Syndrome and Flexor Hallucis Longus Tendinopathy in Dancers: A Systematic Review.

J Dance Med Sci 2018 Mar;22(1):19-32

Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Dancing on pointe and relevé requires extreme plantar flexion of the talo-crural joint. Hence, these positions may lead to posterior ankle impingement syndrome (PAIS). PAIS often coincides with flexor hallucis longus tendinopathy (FHL tendinopathy, or "dancers' tendinitis"). Read More

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http://www.ingentaconnect.com/content/10.12678/1089-313X.22.
Publisher Site
http://dx.doi.org/10.12678/1089-313X.22.1.19DOI Listing
March 2018
25 Reads

Operative Treatment of Posterior Ankle Impingement Syndrome and Flexor Hallucis Longus Tendinopathy in Dancers Open Versus Endoscopic Approach.

J Dance Med Sci 2018 Mar;22(1):11-18

Medical Center for Dancers and Musician, The Hague Medical Center, The Netherlands.

Posterior ankle impingement syndrome (PAIS) is a painful, usually limited plantar flexion of the ankle joint due to soft tissue impingement or a bony impediment often coinciding with tendinopathy of the flexor hallucis longus (FHL) behind the medial malleolus. In persistent complaints, the bony impediment is removed, the tunnel of the FHL tendon is released, or a combination of both procedures has traditionally been performed by open surgery. In 2000, an endoscopic surgical technique for PAIS and FHL tendinopathy was introduced. Read More

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http://www.ingentaconnect.com/content/10.12678/1089-313X.22.
Publisher Site
http://dx.doi.org/10.12678/1089-313X.22.1.11DOI Listing
March 2018
24 Reads

Posterior Ankle Impingement Syndrome and M. Flexor Hallucis Longus Tendinopathy in Dancers Results of Open Surgery.

J Dance Med Sci 2018 Mar;22(1):3-10

Medical Center for Dancer and Musician, The Hague Medical Center, The Netherlands.

Posterior ankle impingement syndrome (PAIS), the result of posterolateral soft tissue or bony impingement of the ankle, and tendinopathy of the flexor hallucis longus (FHL tendinopathy) in the ankle are common in dancers. If conservative treatment of these conditions fails to produce adequate results, surgical intervention might be necessary. However, outcomes of treatment by open surgery for these diagnoses have been described only in small series of dancers. Read More

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http://www.ingentaconnect.com/content/10.12678/1089-313X.22.
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http://dx.doi.org/10.12678/1089-313X.22.1.3DOI Listing
March 2018
10 Reads

Quantification of the Learning Curve for Arthroscopic Os Trigonum Excision.

Authors:
Kotaro Yamakado

J Foot Ankle Surg 2018 May - Jun;57(3):505-508. Epub 2018 Mar 1.

Department Manager, Sports Medicine (Orthopaedics), Fukui General Hospital, Fukui, Japan. Electronic address:

The purpose of the present study was to quantify the learning curve for arthroscopic os trigonum excision using the log-linear model. Twenty-three consecutive feet underwent arthroscopic os trigonum excision and release of the flexor hallucis longus. The required time from the beginning of shaving of the soft tissue until completion of os trigonum excision and release of the flexor hallucis longus (van Dijk time) was recorded. Read More

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http://dx.doi.org/10.1053/j.jfas.2017.11.010DOI Listing
October 2018
7 Reads

Talus Fracture of the Medial Tubercle of the Posterior Process: Interposition of the Flexor Hallucis Longus Tendon.

Authors:
Jin Park Jin Ho Che

J Foot Ankle Surg 2018 May - Jun;57(3):615-617. Epub 2018 Feb 15.

Surgeon and Orthopedist, Department of Orthopedic Surgery, Yonsei Knee and Spine Hospital, Seoul, Republic of Korea.

Talus fracture of the medial tubercle of the posterior process is rare. This type of fracture can be easily missed, because it is difficult to identify on plain radiographs of the ankle. Oblique radiographs with external rotation, computed tomography, and magnetic resonance imaging (MRI) of the ankle are useful for making an accurate diagnosis. Read More

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http://dx.doi.org/10.1053/j.jfas.2017.10.028DOI Listing
October 2018
11 Reads

Surgical management of chronic Achilles tendon ruptures using less invasive techniques.

Foot Ankle Surg 2018 Apr 16;24(2):164-170. Epub 2017 Feb 16.

Department of Orthopaedics, Frimley Health NHS Foundation Trust, Frimley Park Hospital, Portsmouth Road, Camberley, Surrey, GU16 7UJ, United Kingdom.

Background: Surgical management of chronic Tendo Achillis (TA) ruptures usually requires tendon grafting procedures. Several techniques have been described. We examined the outcome of three different less invasive (incisions length less than 3 cm) tendon transfer techniques in the management of patients with a chronic rupture of the TA. Read More

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http://dx.doi.org/10.1016/j.fas.2017.02.002DOI Listing
April 2018
13 Reads

Flexor hallucis longus transfer versus turndown flaps augmented with flexor hallucis longus transfer in the repair of chronic Achilles tendon rupture.

Foot Ankle Surg 2019 Apr 10;25(2):221-225. Epub 2017 Nov 10.

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Background: Repairs of chronic Achilles tendon ruptures are technically challenging due to large defects after scar excision. Multiple techniques for repair have been proposed but little consensus on best practice established. This study aims to compare flexor hallucis longus (FHL) transfers versus turndown flaps augmented by FHL transfers. Read More

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http://dx.doi.org/10.1016/j.fas.2017.10.019DOI Listing
April 2019
33 Reads

Outcomes of flexor digitorum longus (FDL) tendon transfer in the treatment of Achilles tendon disorders.

Foot Ankle Surg 2019 Jun 19;25(3):303-309. Epub 2017 Dec 19.

Medstar Union Memorial Hospital, 3333 Calvert Street, Baltimore, MD, 21218, USA.

Background: In patients with chronic Achilles tendon disorders, Achilles tendon debridement can be supplemented with a tendon transfer, with the flexor hallucis longus tendon (FHL) transfer representing the most common used technique. Our study describes clinical and functional results of patients treated with flexor digitorum longus (FDL) tendon transfer in the treatment of patients with chronic Achilles tendon disorders.

Methods: Retrospective study of prospectively collected data of thirteen patients (15 feet) that underwent FDL tendon transfer as part of the treatment of chronic Achilles tendon disorders. Read More

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http://dx.doi.org/10.1016/j.fas.2017.12.003DOI Listing
June 2019
16 Reads

Endoscopic Transfer of Flexor Hallucis Longus Tendon for Chronic Achilles Tendon Rupture: Technical Aspects and Short-Time Experiences.

Foot Ankle Spec 2018 Oct 17;11(5):461-466. Epub 2018 Jan 17.

Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway (EEH, KHH, AHS).

Background: Chronic Achilles tendon ruptures can lead to reduced power of plantar flexion in the ankle with impaired gait ability. The open 1- or 2-incision technique for flexor hallucis longus transfer has proven good functional outcome but has the disadvantage of relatively extensive surgery performed at a vulnerable location. To reduce the risk of soft tissue problems, the flexor hallucis longus transfer can be performed endoscopically. Read More

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http://dx.doi.org/10.1177/1938640017754234DOI Listing
October 2018
6 Reads

Obtaining Adequate Tension for Extensor Hallucis Longus Tendon Rupture Repair Using Wide-Awake Surgery: A Case Report.

J Foot Ankle Surg 2018 Mar - Apr;57(2):414-417. Epub 2017 Dec 7.

Professor and Chairman, Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan.

Wide-awake surgery has potential advantages for treating extensor or flexor tendon injury. We present a case of chronic extensor hallucis longus injury treated with turn-down reconstruction using wide-awake surgery with a selective nerve block. To the best of our knowledge, this is the first such case reported. Read More

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http://dx.doi.org/10.1053/j.jfas.2017.08.025DOI Listing
September 2018
7 Reads

Flexor Hallucis Longus Muscle and Tendon Transfer for the Treatment of Achilles Tendon Wounds.

Foot Ankle Int 2018 02 24;39(2):205-209. Epub 2017 Nov 24.

3 Department of Orthopaedics, University of Rochester Medical Center, Rochester, NY, USA.

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http://dx.doi.org/10.1177/1071100717739395DOI Listing
February 2018
7 Reads

Tendon split lengthening technique for flexor hallucis longus tendon rupture.

J Orthop Surg Res 2017 Nov 6;12(1):165. Epub 2017 Nov 6.

Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1, Dalim-1dong, Youngdeungpo-gu, Seoul, 150-950, South Korea.

Background: Flexor hallucis longus (FHL) tendon rupture is a challenging injury to lead with clawing of the great toe when the FHL tendon is repaired too tight. When the diagnosis is delayed, the tendon ends may not be opposable because of contracture or poor tendon tissue.

Methods: A technique to reconstruct FHL tendon rupture without a free tendon graft is described. Read More

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http://dx.doi.org/10.1186/s13018-017-0668-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674746PMC
November 2017
10 Reads

What Do You Do With The Achilles if You Have No Fancy Toys?

Foot Ankle Clin 2017 Dec 28;22(4):801-818. Epub 2017 Sep 28.

Indian Foot and Ankle Society; Director, Department of Orthopedics, Noble Hospital, Magarpatta, Hadapsar, Pune 411013, Maharashtra, India.

Surgical management of Achilles disorders warrants excision of the degenerated tendon and removal of impinging bone. Resulting defects can be bridged by various methods. Although FHL is the most commonly used tendon for transfer, large defects in cases of chronic Achilles ruptures may be bridged by use of a distant donor tendon. Read More

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http://dx.doi.org/10.1016/j.fcl.2017.07.008DOI Listing
December 2017
10 Reads

Insertional Tendinopathy of the Achilles: Debridement, Primary Repair, and When to Augment.

Foot Ankle Clin 2017 Dec 27;22(4):761-780. Epub 2017 Sep 27.

Foot and Ankle Service, Rothman Institute at Jefferson, Sidney Kimmel Medical College, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA. Electronic address:

Insertional Achilles tendinopathy is a degenerative enthesopathy associated with pain and dysfunction. Nonsurgical management is first attempted for a period of 3 to 6 months and may consist of physical therapy with eccentric training and other modalities. Surgical treatment can be successful with a variety of approaches. Read More

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http://dx.doi.org/10.1016/j.fcl.2017.07.005DOI Listing
December 2017
17 Reads

Noninsertional Tendinopathy of the Achilles.

Foot Ankle Clin 2017 Dec 28;22(4):745-760. Epub 2017 Sep 28.

University of California, Davis, 4860 Y Street, Suite 1700, Sacramento, CA 95817, USA. Electronic address:

Noninsertional Achilles tendinosis is differentiated from insertional Achilles tendinosis based on anatomic location. Tendinosis, as opposed to tendonitis, is primarily a degenerative process and the role of inflammation is believed limited. The etiology of Achilles tendinopathy may include overuse leading to repetitive microtrauma, poor vascularity of the tissue, mechanical imbalances of the extremity, or combination of these elements. Read More

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http://dx.doi.org/10.1016/j.fcl.2017.07.006DOI Listing
December 2017
49 Reads

Flexor Digitorum Longus (FDL) or Flexor Hallucis Longus (FHL) Harvesting: Technical Tip and Case Studies.

Foot Ankle Int 2017 Nov 1;38(11):1267-1270. Epub 2017 Sep 1.

2 Orthopedics Department, Meir Medical Center, Kfar Saba, Israel.

Background: Harvesting of the flexor digitorum longus (FDL) or the flexor hallucis longus (FHL) is a procedure used when tendon transfer is needed. It is commonly used in tibialis posterior reconstruction and Achilles tendon reconstruction. Harvesting of these tendons is sometimes difficult and time-consuming. Read More

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http://dx.doi.org/10.1177/1071100717722365DOI Listing
November 2017
6 Reads

A Biomechanical Analysis of Interference Screw Versus Bone Tunnel Fixation of Flexor Hallucis Longus Tendon Transfers to the Calcaneus.

J Foot Ankle Surg 2017 Jul - Aug;56(4):813-816

Assistant Professor, Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

The flexor hallucis longus tendon transfer is commonly used to restore function in chronic Achilles tendon ruptures and chronic Achilles tendinopathy. The tendon is often secured to the calcaneus either through a bone tunnel or by an interference screw. We hypothesized that tenodesis using the bone tunnel method would be mechanically superior to interference screw fixation for flexor hallucis longus transfers. Read More

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http://dx.doi.org/10.1053/j.jfas.2017.04.014DOI Listing
March 2018
35 Reads

Biomechanical Analysis of Suture Anchor vs Tenodesis Screw for FHL Transfer.

Foot Ankle Int 2017 Jul 2;38(7):797-801. Epub 2017 May 2.

6 Bioengineering-Biomechanics Laboratory, The Feinstein Institute for Medical Research, Manhasset, NY, USA.

Background: Chronic Achilles injury is often treated with flexor hallucis longus (FHL) tendon transfer to the calcaneus using 1 or 2 incisions. A single incision avoids the risks of extended dissections yet yields smaller grafts, which may limit fixation options. We investigated the required length of FHL autograft and biomechanical profiles for suture anchor and biotenodesis screw fixation. Read More

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http://dx.doi.org/10.1177/1071100717702848DOI Listing
July 2017
54 Reads

Soleus Atrophy Is Common After the Nonsurgical Treatment of Acute Achilles Tendon Ruptures: A Randomized Clinical Trial Comparing Surgical and Nonsurgical Functional Treatments.

Am J Sports Med 2017 May 10;45(6):1395-1404. Epub 2017 Mar 10.

Division of Orthopaedic and Trauma Surgery, Department of Surgery, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.

Background: It remains controversial whether nonsurgical or surgical treatment provides better calf muscle strength recovery after an acute Achilles tendon rupture (ATR). Recent evidence has suggested that surgery might surpass nonsurgical treatment in restoring strength after an ATR.

Purpose: To assess whether magnetic resonance imaging (MRI) findings could explain calf muscle strength deficits and the difference between nonsurgical and surgical treatments in restoring calf muscle strength. Read More

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http://dx.doi.org/10.1177/0363546517694610DOI Listing
May 2017
36 Reads

Incidence and Association of CT Findings of Ankle Tendon Injuries in Patients Presenting With Ankle and Hindfoot Fractures.

AJR Am J Roentgenol 2017 Feb;208(2):373-379

1 Department of Radiology, The University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.116, Houston, TX 77030.

Objective: Tendon injuries are a commonly encountered finding in ankle CT examinations performed for fractures. This study was designed to identify the incidence and associations of tendon injuries in ankle CT examinations performed for fractures.

Materials And Methods: A retrospective review was performed of 410 patients who underwent ankle CT during a 6-year period. Read More

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http://dx.doi.org/10.2214/AJR.16.16657DOI Listing
February 2017
27 Reads

Z-plasty of the flexor hallucis longus tendon at tarsal tunnel for checkrein deformity.

J Orthop Surg (Hong Kong) 2016 12;24(3):354-357

Departments of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Korea.

Purposes: To review the outcome of Z-plasty of the flexor hallucis longus (FHL) tendon at the tarsal tunnel for checkrein deformity in 8 patients.

Methods: Records of 6 males and 2 females aged 14 to 67 (mean, 39.5) years who underwent Z-plasty (lengthening) of the FHL tendon at the tarsal tunnel for checkrein deformity in the first and second toes by a single surgeon were reviewed. Read More

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http://dx.doi.org/10.1177/1602400316DOI Listing
December 2016
77 Reads

Repair of Chronic Achilles Ruptures Has a High Incidence of Venous Thromboembolism.

Foot Ankle Spec 2017 Oct 23;10(5):415-420. Epub 2016 Nov 23.

Saginaw Valley Bone and Joint Center, Saginaw, Michigan (MJB).

Background: Despite the low incidence of deep vein thrombosis (DVT) in foot and ankle surgery, some authors report a high incidence of symptomatic DVT following Achilles tendon rupture. The purpose of this study was to identify DVT risk factors inherent to Achilles tendon repair to determine which patients may benefit from prophylaxis.

Methods: One hundred and thirteen patient charts were reviewed following elective and nonelective Achilles tendon repair. Read More

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http://dx.doi.org/10.1177/1938640016679706DOI Listing
October 2017
28 Reads

Combined flexor hallucis longus tendon transfer and gastrocnemius recession for reconstruction of gapped chronic achilles tendon ruptures.

Injury 2016 Dec 3;47(12):2833-2837. Epub 2016 Nov 3.

Assisstant Prof of Orthopedic Surgery, Mansoura University, Egypt. Electronic address:

Objective: The aim of this study was to assess the functional outcomes after a combined FHL transfer and a gastrocnemius recession for treatment of chronic ruptures of Achilles tendon with a gap and to investigate the patient's satisfaction about the great toe function after transfer.

Material And Methods: 19 patients with chronic rupture of the Achilles tendon with a gap were treated with a flexor halluces longus tendon transfer combined with a gastrocnemius recession, Clinical diagnosis depends on the presence of gap in the tendon on examination, inability of tip toe walking on the affected side and positive calf-squeeze test, MRI was used to confirm the clinical diagnosis. American Orthopedic Foot & Ankle Society hind foot score was used for assessment of the results. Read More

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http://dx.doi.org/10.1016/j.injury.2016.10.029DOI Listing
December 2016
8 Reads

Reconstruction of Kuwada grade IV chronic achilles tendon rupture by minimally invasive technique.

Indian J Orthop 2016 Sep;50(5):523-528

Department of Orthopaedics, Institute of Orthopaedic Research, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, P. R. China.

Background: Transfer of a flexor hallucis longus (FHL) tendon can not only reconstruct the Achilles tendon but also provide ischemic tendinous tissues with a rich blood supply to enhance wound healing. This retrospective study aims to investigate clinical outcomes in patients who underwent repair of Kuwada grade IV chronic Achilles tendon rupture with long hallucis longus tendons harvested using a minimally invasive technique.

Materials And Methods: 35 patients who were treated for Kuwada grade IV Achilles tendon injuries from July 2006 to June 2011 were included in this retrospective study. Read More

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http://dx.doi.org/10.4103/0019-5413.189599DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017175PMC
September 2016
28 Reads