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

MedStar author(s):
Citation: Journal of Foot & Ankle Surgery. 2017 Dec 19PMID: 29409178Institution: MedStar Union Memorial HospitalDepartment: Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2017Local holdings: Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007ISSN:
  • 1268-7731
Name of journal: Foot and ankle surgery : official journal of the European Society of Foot and Ankle SurgeonsAbstract: 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.CONCLUSIONS: FDL tendon transfer represent an operative alternative in the treatment of chronic Achilles tendon disorders. Our study showed good clinical outcomes with low complications and donor site morbidity.Copyright (c) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.LEVEL OF EVIDENCE: Observational study, case series - level IV.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. Preoperative and postoperative assessment included visual analogue score (VAS) for pain, SF-36 survey and lower extremity functional scale (LEFS). The average follow-up was 26.4 (range, 14-56) months. Patients were also assessed for ability to perform single leg heel rise test, muscle power for plantar flexion of the lesser toes, surgical scar condition and associated complications.RESULTS: At final follow-up, we found significant postoperative improvement in VAS score (6.6+/-2.99 vs 1.06+/-1.43; p<.0001), SF-36 physical component summary (PCS) (28.20+/-10.71 vs 45.04+/-11.19; p<.0001) and LEFS (36.13+/-20.49 vs 58.73+/-18.19; p<.0001). Twelve patients (92%) could perform a single leg heel rise test in the operated extremity, although there was significant difference when comparing operated and uninvolved sides (4.86+/-3.36cm vs 7.18+/-3.40cm; p=.0002). One patient reported weakness for plantar flexion of the lesser toes, without balance or gait disturbances. Two patients (2 feet, 13.3%) had superficial infections and one patient (one foot, 6.6%) needed operative debridement for a deep infection.All authors: Chinanuvathana A, de Cesar Netto C, Dein EJ, Fonseca LFD, Schon LC, Tan EWFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2018-02-20
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Journal Article MedStar Authors Catalog Article 29409178 Available 29409178

Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007

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.

CONCLUSIONS: FDL tendon transfer represent an operative alternative in the treatment of chronic Achilles tendon disorders. Our study showed good clinical outcomes with low complications and donor site morbidity.

Copyright (c) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

LEVEL OF EVIDENCE: Observational study, case series - level IV.

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. Preoperative and postoperative assessment included visual analogue score (VAS) for pain, SF-36 survey and lower extremity functional scale (LEFS). The average follow-up was 26.4 (range, 14-56) months. Patients were also assessed for ability to perform single leg heel rise test, muscle power for plantar flexion of the lesser toes, surgical scar condition and associated complications.

RESULTS: At final follow-up, we found significant postoperative improvement in VAS score (6.6+/-2.99 vs 1.06+/-1.43; p<.0001), SF-36 physical component summary (PCS) (28.20+/-10.71 vs 45.04+/-11.19; p<.0001) and LEFS (36.13+/-20.49 vs 58.73+/-18.19; p<.0001). Twelve patients (92%) could perform a single leg heel rise test in the operated extremity, although there was significant difference when comparing operated and uninvolved sides (4.86+/-3.36cm vs 7.18+/-3.40cm; p=.0002). One patient reported weakness for plantar flexion of the lesser toes, without balance or gait disturbances. Two patients (2 feet, 13.3%) had superficial infections and one patient (one foot, 6.6%) needed operative debridement for a deep infection.

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