Endoscopic FHL Transfer for Acute Achilles Tendon Rupture

A Case Series of Endoscopic Flexor Hallucis Longus Transfer for Acute Achilles Tendon Rupture.

This observational study aims to evaluate the outcome of endoscopic flexor hallucis longus transfer (FHLt) in patients with acute Achilles tendon rupture (AATR).

This evaluation will be performed by examining the following parameters:

1. Patient satisfaction quantified with the Achilles tendon Total Rupture Score (ATRS). This is the primary outcome.
2. Complication rate
3. Ankle and Calf circumference compared to the contralateral healthy limb.
4. Passive and Active range of ankle motion compared to the contralateral healthy limb.
5. Hallux flexion force compared to the contralateral healthy limb.

Inclusion Criteria:

• Signed Consent Form
• Acute Achilles Tendon Rupture (<4 weeks)
• Underwent operative treatment with Endoscopic Flexor Hallucis Longus transfer
• More than 24 months postoperative follow-up
• Patients operated after 2015

Exclusion Criteria:

• Inability or Unwillingness to cooperate
• Medically unfit for examination
• Age less than 18 or more than 75 years
• Non-operative Management or any other Surgical Management
• Neglected Achilles Tendon Rupture (>4 weeks)
• Bilateral Achilles Tendon Rupture
• Patients operated before 1.1.2015 or after 1.1.2023
• Comorbidities interfering with the secondary outcomes (e.g. Venous insufficiency resulting in lower limb excessive edema interferes with ankle and calf circumference, rheumatoid arthritis and/or previous foot and ankle surgery interferes with active and passive range of motion of the ankle, etc)