Endoscopic Transposition of the Flexor Hallucis Longus to the Heel Tuberosity for Chronic Achilles Tendon Ruptures: Surgical Technique and Literature Review

Introduction: In 25% of cases, Achilles tendon injuries are diagnosed with a delay. A large number of techniques for reconstructing chronic soft tissue injuries have been proposed, ranging from local tissue plasticity to Achilles tendon endoprosthetics. The main problem that arises during large reconstructions of the Achilles tendon is the risk of postoperative infectious complications, associated with the peculiarities of blood supply to the posterior surface of the lower leg. To minimize such complications, a method of endoscopic transposition of the long flexor tendon of the first toe to the calcaneus has been proposed. Purpose of the study: demonstration the method of endoscopic transposition of the long flexor tendon of the first toe to the calcaneus with a step-by-step description, as well as to review the current literature on the transposition of the long flexor tendon of the first toe.

Materials and Methods: We demonstrated the methodology for performing the surgical intervention and conducted an analysis of the literature data from scientific article databases such as PubMed, Google Scholar, Elibrary, and Cyberleninka over the past 10 years using the method of endoscopic transposition of the long flexor tendon of the first toe to the calcaneus.

Conclusions: Endoscopic transposition of the long flexor tendon of the first toe in chronic ruptures of the Achilles tendon is an effective and minimally invasive technique that does not lead to significant biomechanical disturbances. However, the procedure requires expensive equipment and the corresponding surgical skills of the physician, which may limit the widespread use of this technique.

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