Reconstruction for Missed or Neglected Achilles Tendon Rupture with V-Y Lengthening and Flexor Hallucis Longus Tendon Transfer through One Incision

Background: The purpose of this study was to introduce a novel operative technique and to evaluate the clinical outcomes in a cohort of patients with missed or neglected Achilles tendon ruptures. Methods: Fifteen consecutive patients with missed complete Achilles tendon ruptures and 5-cm or larger gaps had reconstruction with V-Y lengthening and flexor hallucis longus tendon transfer through a single incision. The patients were evaluated at an average of 106 weeks after surgery. At the time of followup, all patients were assessed with regard to their self-reported level of satisfaction and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Ankle strength and active range of motion were evaluated using Biodex® (Biodex Medical Systems, Shirley, NY) isokinetic dynamometry. In addition, seven patients were evaluated using diagnostic ultrasound. Results: We found a 7.7 N-m (–22.3%) loss of plantarflexion torque at 60 degrees/sec and a 3.5 N-m (–13.5%) loss of plantarflexion torque at...