Outcome of Single Incision Flexor Hallucis Longus Transfer for Chronic Achilles Tendinopathy

Background: Chronic Achilles tendinopathy may require tendon transfer for treatment. Relatively few studies have reported the clinical outcome for flexor hallucis longus (FHL) transfer for chronic Achilles tendinopathy. Both single and double incision techniques have been reported. We present our series of a single incision technique. Materials and Methods: A retrospective study measured the clinical outcomes of 19 patients with chronic Achilles tendinopathy treated with single incision FHL transfer. Patients were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot instrument, AOFAS hallux instrument as well as pre and postoperative visual analog scales (VAS) for pain. Results: Average AOFAS ankle/hindfoot score was 96.4 +/- 5.7. Average AOFAS hallux score was 92.4 +/- 6.6. Average pre and postoperative VAS was 7.5 +/- 2.7 and 0.6 +/- 1.0, respectively. No tendon reruptures, wound complications or hallux deformities occurred. Conclusion: Excellent clinical outcomes with significant decrease in pain are possible with single incision technique for FHL, transfer for chronic Achilles tendinopathy.