MANAGEMENT OF CHRONIC ACHILLES TENDON RUPTURES BY RECONSTRUCTING WITH FLEXOR HALLUCIS LONGUS AND PERONEUS BREVIS TENDONS: A COMPARATIVE STUDY.

CORRESPONDING AUTHOR:
Dr. Ananthula Krishna Reddy,
Bhuvana Hospital
H. No. 3-13/3, Mallikarjuna Nagar,
Peerzadi Guda, Opp: Uppal Bus depot,
Hyderabad-39, Telangana.
E-mail: kr_dr@ymail.com

ABSTRACT: Though, The Achilles tendon is the strongest and thickest tendon in the body, it is the one which commonly ruptures. Achilles tendon ruptures are commonly seen in agricultural labour, in our country. Local steroid injections for retro calcaneal pain is one of the common risk factors. The usual Mechanism of injury is a violent dorsi flexion in a plantar flexed foot. Achilles tendon is relatively hypovascular in 3-6cms above its calcaneal insertion and repetitive micro injuries in this region is the main pathology behind the degenerative rupture of this tendon. Acute traumatic TA cuts can be managed easily but the problem is with chronic degenerative ruptures, for which various procedures were described. When the gap is less than 3cm, end to end repair with or without v-y plasty, when the gap is more than 3 cm augumentation with flexor hallucis longus and peroneus brevis tendons are popular among them. Both peronius brevis (PB) and Flexor hallucis longus (FHL) tendons are vascular and dynamic structures which helps in augumenting the healing at repair site.

In our study, though AOFAS scores were slightly more encouraging for FHL, over PB, both the procedures i.e. Flexor hallucis longus and Peroneus brevis tendon transfers yielded good to excellent results in chronic ruptures of more than 4 weeks old and with more than 3cm gap.

KEYWORDS: Achilles tendon; rupture; Peroneus brevis tendon; Flexor hallucis longus.