Minimally Invasive Percutaneous Tendon Transfer of Extensor Digitorum Longus Second Toe to Extensor Hallucis Longus for Chronic Traumatic Extensor Hallucis Longus Rupture: Technical Description
Aim and background: The management of chronic extensor hallucis longus (EHL) tendon ruptures presents a challenge. While primary suturing is feasible in acute cases, the challenge lies in treating chronic ruptures, as the gap between torn edges widens due to tendon contracture, rendering direct end-...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2024-04-01
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| Series: | Journal of Foot and Ankle Surgery (Asia Pacific) |
| Subjects: | |
| Online Access: | https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1332 |
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| Summary: | Aim and background: The management of chronic extensor hallucis longus (EHL) tendon ruptures presents a challenge. While primary suturing is feasible in acute cases, the challenge lies in treating chronic ruptures, as the gap between torn edges widens due to tendon contracture, rendering direct end-to-end repair unviable. Despite the variety of reconstruction methodologies available, a definitive consensus on the optimal technique remains elusive. The innovative approach to minimally invasive percutaneous tendon transfer of the extensor digitorum longus (EDL) from the second toe to the EHL for chronic traumatic EHL rupture holds promise as an alternative solution.
Technique: The goal of surgical treatment was to restore normal gait by realigning the hallux and restoring its capacity to actively extend. For a minimally invasive approach, in this case, four small incisions of size 1 cm were made for the tendinous transfer of the EDL of the second toe to the EHL, making use of a Pulvertaft technique.
Conclusion: By providing a less invasive alternative to traditional reconstructive approaches, this method addresses the limitations of functional compromise associated with common graft or transfer procedures. The described approach not only overcomes the challenges posed by tendon retraction and degeneration but also decreases the risks of donor site morbidity and disease transmission.
Clinical significance: As the field continues to explore advanced surgical techniques, the minimally invasive percutaneous tendon transfer stands out as a valuable addition to the armamentarium of treatments for chronic EHL ruptures. |
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| ISSN: | 2348-280X 2394-7705 |