ArticleMusculoskeletal surgery2025
Clinical and biomechanical comparison of suture-external button versus interference screw associated with V-Y advancement or turndown flaps for flexor hallucis longus transfer in chronic Achilles tendon rupture.
Article in Musculoskeletal surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
Abstract
purposeSurgical treatment of chronic Achilles tendon rupture is a technically challenging procedure. We aimed to compare the clinical outcomes, range of motion, and strength of ankle plantar- and dorsiflexors between two techniques for fixation of flexor hallucis longus tendon to the calcaneus: interference screw and suture-external button.
methodsTwenty-five patients participated in this retrospective comparative study. All patients underwent short harvest FHL tendon transfer for chronic AT rupture were asked for a follow-up visit, at least one year following surgery. The outcomes were evaluated by visual analog scale (VAS), AOFAS ankle-hindfoot score, and VISA-A questionnaire. Ankle ROM with possible restriction in addition to isokinetic strength of ankle plantar- and dorsiflexors was assessed.
resultsNo statistically significant difference was observed between the groups for pain (P = 0.81), AOFAS ankle-hindfoot scale (P = 0.97), and VISA-A (P = 0.44). Notably, more decrease in ankle dorsiflexion was seen in interference screw group in comparison with suture-external button group (4.4 ± 6.6 vs. 9.5 ± 6.1 degrees, P = 0.06). The difference of active dorsiflexion between operated and non-operated side in interference screw group was statistically significant (P = 0.02). Biotenodesis screw imposed more limb asymmetry in comparison with suture-external button technique.
conclusionsFixation of transcalcaneal FHL tendon transfer for chronic AT either by interference screw or suture-external button has encouraging postoperative clinical results. Although ROM of the ankle joint reduced in both techniques, interference screw may result in more reduction in dorsiflexion of the ankle.
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