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CHRONIC ACHILLES TENDON RUPTURES: THE BIOMECHANICAL EFFECTS OF FLEXOR HALLICUS LONGUS AUGMENTED REPAIR ON GAIT.



Abstract

The surgical treatment of chronic Achilles tendon ruptures is essential to restore the normal gait pattern. There are a variety of surgical techniques described, including primary repair, augmentation with tendon transfers, augmentation with aponeurosis flaps and bridging techniques. In recent times augmentation with tendon transfers or aponeurosis flaps are the most commonly performed procedures. Our study examined the biomechanical effect of using the flexor hallicus longus in an augmented chronic Achilles tendon repair on gait pattern and forefoot loading distribution using pedobaragraphical analysis.

We, pedobarographically examined the gait patterns of 10 patients who had undergone augmented chronic Achilles tendon repair using the flexor hallicus longus tendon. The mean age at the time of injury was 59 years of age (range 46–70). The mean follow-up time was 38 months. All patients reported good to excellent results. The mean AOFAS ankle score was 96.25 (range 90–100). There was no statistically significant difference between the loading distributions of the operated foot relative to the contralateral side.

While there is no comparative study examining the outcomes of the varying surgical techniques for chronic Achilles tendon repair, the use of the flexor hallicus longus tendon in augmented chronic Achilles tendon repair has been proven as an effective repair to restore normal function while not compromising the biomechanics of the 1st ray or the loading distribution of the forefoot.

The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.