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

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. Material and Method. An endoscopic technique for flexor hallucis longus transfer is presented together with the experiences from the first six patients operated with this method. Results. No wound healing problems or infections. Five of 6 patients managed single leg heel raise on the affected side 12 months after surgery. Conclusion. The functional results are promising. The soft tissue dissection is minor, and no patients had postoperative wound healing problems or infection. Endoscopic flexor hallucis longus transfer may be an operative procedure that can be considered also in patients with potential wound healing problems. Levels of Evidence: Level IV: Technical note/case series without control