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Achilles Reconstruction :Flexor Hallucis Longus tendon transfer using Arthrex Biotenodesis screw

Overview

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Learn the Achilles Reconstruction :Flexor Hallucis Longus tendon transfer using Arthrex Biotenodesis screw surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Achilles Reconstruction :Flexor Hallucis Longus tendon transfer using Arthrex Biotenodesis screw surgical procedure.

The Flexor Hallucis Longus transfer for Achilles reconstruction is a straight-forward and effective operation for salvaging various situations which have resulted in a deficient and de-functioned Achilles tendon.

The flexor hallucis longus tendon is easily accessed sitting just anterior to the Achilles tendon and can be safely harvested  as long as care is taken to identify and avoid the posterior tibial neuro-vascular bundle. It has not been my experience in performing this procedure for over 15 years that any more than a single incision is required to access and harvest adequate length of the FHL for reconstruction. If the tendon is slightly too short for a bone anchor it can be woven into the native Achilles insertion and sutured.

The Arthrex Biotenodesis screw is a useful implant to anchor the harvested tendon into the calcaneus, though the tendon can be woven into the native Achilles insertion also. The key is appropriate tensioning of the transfer.

Despite the slightly more involved nature of surgery compared to primary Achilles repair  the period of immobilisation and recovery and outcome are little different.

 

 

 

Author:Mark Herron FRCS.

Institution:  The Wellington Hospital, London, UK.

Surgical Steps

Welcome to the surgical steps quiz.

This tests your ability to recall the correct order in which the key steps of an operation should be performed.

There will be various legitimate variations in this order but the quiz doesn’t reflect this.
Your reference point for the steps quiz is just our operative technique.
It’s one starting point in helping you to learn the technique.

  • You simply “drag & drop” the boxes containing the descriptions of the steps into the order you think fits and submit for marking.
  • If you get it correct first time you will be presented your certificate at the end of the quiz.
  • If you need to do more work on the steps you access your marked version by clicking the“re-sit the quiz” button.
  • This will show the steps you ordered correctly highlighted in green and the incorrect ones in red.
  • The correct green steps are fixed and won’t move.
  • The red steps move differently after your initial attempt and swap locations with the step they are dragged and dropped onto .
  • Finally resubmit the quiz once again.
  • The quiz will let you keep going until you get all the steps in the right order.
  • The correct green steps are fixed and won’t move.
  • The red steps move differently after your initial attempt and swap locations with the step they are dragged and dropped onto .
  • Finally resubmit the quiz once again.
  • The quiz will let you keep going until you get all the steps in the right order.

COURSE PROGRESS

Surgical Steps

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