FUNCTIONAL OUTCOME OF FLEXOR HALLUCIS LONGUS TRANSFER AUGMENTED WITH GASTROCNEMIOUS TURNDOWN FLAP IN THE RECONSTRUCTION OF CHRONIC ACHILLES TENDON RUPTURE

Abstract

Introduction Chronic spontaneus rupture of Achilles tendon commonly occurs in middle aged and elderly person, which often goes undiagnosed or untreated for long duration, resulting in large gap in between two ruptured ends. Disrupted Tendo Achilles causes weakness in plantar exion of foot and abnormal gait. Surgical repair of the chronic rupture have poor result due to large gap in between ends. Different surgical procedures are described in the literature for Reconstruction of chronic Tendo Achilles injuries without any clear superior technique. Purpose of this study is assessment of functional outcome of Flexor Hallucis Longus transfer augmented by turn down Gastrocnemius ap in chronic Tendo achilles rupture. Methods This study Assessed functional outcome of Chronic achilles tendon rupture, reconstructed by Flexor Hallucis Longus transfer augmented by turndown gastrocnemius ap done at orthopaedics department, Bankura Sammilani medical college between november 2020 to october 2021. Patients were followed up for 12 months and then assessed clinically for range of movement , return to normal mobility , persistance of pain and complications . Functional outcome were assesed by American Orthopaedic Foot and Ankle Society(AOFAS) ankle and hindfoot score and Visual analogue Score (VAS). Observations Out of 8 patients, 6 had Excellent AOFAS score of 90 to 100, while 2 patient had a good score of 80 to 89. None had fair or poor score.None of the patients had wound breakdown, ankle stiffness, persistant nerve palsy or rerupture of the reconstructed tendon. Mean VAS score for pain at 12 month follow for 8 patients was 0, as none had any pain complain. None of the patient had any loss of ankle joint movement or stability, All patient resumed there normal day to day activity but none could restart recreational or sporting activity. Conclusions. Flexor Hallucis Longus transfer with turndown ap augmentation gives good to excellent outcome with minimal complication, if meticulous soft tissue handling and proper wound closure are done.