Chronic Achilles Tendon Repair: Minimally Invasive Turndown Technique With Flexor Hallucis Longus Tendon Transfer

Abstract

Achilles tendon ruptures have shown an increased incidence over the past decades. Of those, an estimated 25% are missed at the first presentation. Chronic Achilles tendon ruptures are routinely retracted and unable to be primarily repaired end-to-end. To provide enough length to allow repair, procedures such as V-Y lengthening, central turndown, or grafting are often necessary. Several lengthening techniques have been described, but there is no gold standard. Complications associated with these varying techniques include wound necrosis and infection. We describe a minimally invasive Achilles tendon central turndown technique for performing chronic Achilles tendon repairs while minimizing wound risk and avoiding use of allograft. Level of Evidence: Level V.