Achilles tendon reconstruction combining a modified Dresden technique and endoscopic flexor hallucis longus transfer

Objective: The purpose of this paper is to describe a minimally invasive chronic Achilles tendon rupture reconstruction combining a modified Dresden technique and endoscopic flexor hallucis longus (FHL) tendon transfer. Methods: Our prospectively collected database was queried for patients presenting with chronic Achilles tendon rupture. Patients were included if they presented any of the following criteria: more than 65 years of age, history of previous DVT, active smoking habit and Diabetes. Pre and post-operative SF-36 and AOFAS hindfoot scores, complications, and patient satisfaction grades were recorded. Results: Eight patients met the inclusion criteria; the median age was 49 years old (range 22 - 67 years). Two complications were registered (sural neuritis and minor wound dehiscence). Mean AOFAS score increased from 48 (range 40 - 63) to 91,6 (range 85 - 95). Regarding SF-36 score, the SFF-36 improved from 51,6 to 79,3 points and the SFM-36 enhance from 25 to 61,5 points. All patients evaluated their satisfaction regarding the performed procedure as satisfactory. Conclusion: Chronic Achilles tendon rupture reconstruction combining a modified Dresden technique and endoscopic FHL transfer is an attractive option in high-risk patients, with favorable results at the short-term follow-up. Level of Evidence IV; Therapeutic Study; Case Series.