Journal article
Outcomes of flexor digitorum longus (FDL) tendon transfer in the treatment of Achilles tendon disorders
Foot and ankle surgery, Vol.25(3), pp.303-309
06/2019
DOI: 10.1016/j.fas.2017.12.003
PMID: 29409178
Abstract
•Flexor digitorum longus (FDL) tendon transfer represents a surgical option in the treatment of chronic Achilles tendon disorders.•We found significant improvement in VAS score, SF-36 physical component summary (PCS) and Lower Extremity Functional Scale (LEFS).•Only one patient reported weakness for plantar flexion of the lesser toes, without balance or gait disturbances.•Technique should be considered as an alternative for the FHL tendon transfer, especially in the more active and young population.•We found comparable clinical and functional outcomes, with low incidence of complications and donor site morbidity.
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.
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.
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 ± 3.36 cm vs 7.18 ± 3.40 cm; 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.
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.
Observational study, case series – level IV.
Details
- Title: Subtitle
- Outcomes of flexor digitorum longus (FDL) tendon transfer in the treatment of Achilles tendon disorders
- Creators
- Cesar de Cesar Netto - Medstar Union Memorial Hospital, 3333 Calvert Street, Baltimore, MD, 21218, USAApisan Chinanuvathana - Medstar Union Memorial Hospital, 3333 Calvert Street, Baltimore, MD, 21218, USALucas Furtado da Fonseca - Medstar Union Memorial Hospital, 3333 Calvert Street, Baltimore, MD, 21218, USAEric J Dein - Johns Hopkins University, School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USAEric W Tan - University of Southern California, Keck School of Medicine, 1520 San Pablo street, Suite 2000, Los Angeles, CA, 90033, USALew Charles Schon - Medstar Union Memorial Hospital, 3333 Calvert Street, Baltimore, MD, 21218, USA
- Resource Type
- Journal article
- Publication Details
- Foot and ankle surgery, Vol.25(3), pp.303-309
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.fas.2017.12.003
- PMID
- 29409178
- ISSN
- 1268-7731
- eISSN
- 1460-9584
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040484902771
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