• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.110-113
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• 2011

Ossification of the Achilles tendon is a rare condition that is characterized by the presence of an ossific mass contained within the substance of the tendon. The ossified mass is usually asymptomatic but when it grows large and painful, it deteriorates the function of Achilles tendon. We report a case of ossification of the Achilles tendon, which was successfully treated by removal of the ossific mass and proximal flexor hallucis longus (FHL) tendon transfer.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.168-172
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• 2006

Purpose: Theaim of this study was to review the results of treatment for deep infection following repair of Achilles tendon rupture using reverse sural arterialized flap and/or flexor hallucis longus transfer. Materials and Methods: Five cases of Achilles tendon infection in five patients were treated using reverse sural arterialized flap and/or flexor hallucis longus transfer at our hospital with followed up of average 23.6 months (range, 13-43 months). Three patients were male and average age at surgery was 52.0 years (range, 42-59 years). Clinical results were evaluated by the method of Percy and Conochie, and the isokinetic peak torque value was interpreted according to the guideline of Sapega. Results: The clinical result was excellent in three cases, good in one case and fair in one case. The isometric peak torque value for $30^{\circ}$ per second was normal in two cases, possibly abnormal in one case, and probably abnormal in two cases, and for $120^{\circ}$, normal in one case, probably abnormal in four cases. Five cases in five patients were satisfied with the result of treatment. Conclusion: We can expect satisfactory results of treatment for deep infection following repair of Achilles tendon rupture using reverse sural arterialized flap and/or flexor hallucis longus transfer.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.114-117
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• 2015

Deep infection of Achilles tendon is one of the serious complications that occur after open repair of the tendon. It sometimes leads to a very large tendon defect during the course of treatment. We report on a case of massive defect in Achilles tendon, which was successfully treated with Achilles tendon allograft and flexor hallucis longus tendon transfer.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.23-27
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• 2009

Purpose: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. Materials and Methods: Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. Results: The length of the gap after debridement was $5.4{\pm}2.0$ cm. The VAS improved from $4.1{\pm}0.9$ to $1.5{\pm}0.8$ at last follow up (p<0.05). The AOFAS score increased from $38.9{\pm}12.2$ to $91.5{\pm}8.9$ at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. Conclusion: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.27-27
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• 2008

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.133-137
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• 2009

Purpose: The purpose of this study was to evaluate the clinical results of the old Achilles tendon rupture treated with modified flexor hallucis longus (FHL) tendon transfer. Materials and Methods: Seventeen patients with old Achilles tendon rupture treated with modified FHL tendon transfer between March 2004 and February 2008 were enrolled in this study. Technically FHL was pass through the distal portion of the ruptured tendon instead of the drilled hole made on the calcaneus. The mean age of the patients was 37 years (range, 22~67 years), mean follow-up period was 28 months (range, 12~30 months). Patients' subjective satisfaction, calf circumferential diameter, range of motion of ankle and AOFAS ankle-hind foot score and Arner-Lidholm score was evaluated. Results: The average gap between the ruptured tendon was 52 mm (range, 47~56 mm). The AOFAS score improved from 47 pre-operatively to 91 points at the last follow-up. Sixteen patients were satisfied with the result free from discomfort, a patient had mild discomfort who had DM. fourteen patients had decreased range of motion less than 5 degrees while 2 patients had more than 7 degrees decrease compared to the intact side but had no discomfort in daily activities. Nine patients had less than 1 cm calf circumferential diameter difference and 7 patients had 1 to 3 cm diameter difference compared to the intact side. One who had more than 3 cm diameter difference had deteriorated muscle strength. Conclusion: Modified FHL tendon transfer can be a useful technique for the treatment of old Achilles tendon rupture when the gap is with large gap placed too proximal.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.201-203
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• 2005

Although Achilles tendinitis is a relatively common disease, tuberculous involvement of Achilles tendon is rare. We report a case of tuberculous Achilles tendinitis, which was successfully treated with chemotherapy and a combined surgical procedure (Achilles tendon parital excision and FHL tendon transfer).

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.109-114
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• 2010

Purpose: The purpose of this study was to report the surgical outcome of reconstruction of neglected chronic Achilles tendon ruptures with various methods including Achilles tendon allograft. Materials and Methods: Between October 2003 and November 2008, 8 consecutive neglected chronic Achilles tendon ruptures with the defect gap of more than 4 cm underwent surgical reconstruction including V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus transfer and Achilles tendon allograft. There were 7 males and 1 female who were evaluated at more than 18 months after surgery. At the time of followup, all patients were assessed with regard to postoperative complications, their self-reported level of satisfaction, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, 10 repetitive single heel rise, single leg hopping test, and ankle range of motion. Results: The AOFAS score increased from average 71.4 (50-87) to 96.4 (86-100). All patients were able to perform 10-repetitive single heel raise and single leg hopping at the latest follow up. No patient experienced wound complications and deep infection. Six patients were rated as 'excellent' and the other two as 'good'. Conclusion: Neglected chronic Achilles tendon ruptures could be successfully treated with careful selection of the reconstruction method according to the amount of defect gap. With an extensive defect, Achilles tendon allograft can be a good option when the reconstruction is not feasible otherwise.