Endoscopic versus open flexor hallucis longus tendon transfer for reconstruction of chronic achilles tendon rupture: A prospective randomized pilot trial.
Abdelrahman Abdelsalam Afifi, Ayman Ibrahim Fathy Hewaidy, Ossama AbdelRaof El Shazly, Amr Farouk, Awab Ali Mousa Elaslaby, Mahmoud Ahmed Gamal, Mohamed Ahmed El Mowafi
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引用次数: 0
Abstract
Background: Chronic Achilles tendon rupture often requires surgical reconstruction. Flexor hallucis longus (FHL) tendon transfer is widely used, and endoscopic techniques may reduce soft-tissue morbidity and facilitate early recovery.
Methods: Thirty patients with chronic Achilles tendon rupture were randomized to undergo open or endoscopic FHL tendon transfer. Functional outcome was assessed using the Foot and Ankle Ability Measure (FAAM) over 18 months. Secondary outcomes included operative time and wound complications. Exploratory outcomes included postoperative pain assessed by visual analog scale (VAS), duration of analgesic use, and time to return to work.
Results: FAAM scores improved significantly in both groups over time (P < .001), with no significant difference between techniques at final follow-up (P = .487). Operative time was significantly longer in the endoscopic group (P < .001). Wound complications occurred only in the open group, affecting 5 of 15 patients (33.3%). Endoscopic reconstruction was associated with shorter duration of analgesic use (P = .007) and earlier return to work (P = .013). VAS pain scores decreased significantly in both groups with no significant between-group differences.
Conclusions: Both open and endoscopic FHL tendon transfer provided excellent functional outcomes in the management of chronic Achilles tendon rupture. The endoscopic technique was associated with fewer wound complications and improved early postoperative recovery, despite longer operative time.
Level of evidence: Level II, randomized controlled trial (pilot).
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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