Lui Tun Hing
Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China.
Arthrosc Tech. 2015 Dec 14;4(6):e811-4. doi: 10.1016/j.eats.2015.08.008. eCollection 2015 Dec.
Flexor hallucis longus (FHL) tendon transfer is indicated for reconstruction of the Achilles tendon with a gap larger than 5 cm. The tendon can be harvested at zone 2 or zone 3 by minimally invasive techniques with the advantage of minimal soft-tissue dissection. The tendon can be harvested under the sustentaculum tali by zone 2 FHL tendoscopy. It is adequate for FHL transfer to the posterior calcaneal tubercle. If a double-thickness reconstruction of a huge gap of the Achilles tendon is indicated, the tendon can be harvested at the level of the hallux by means of a tendon stripper. However, the interconnection tendon of the master knot of Henry can be split together with the FHL or flexor digitorum longus tendon instead of being cut. Zone 2 FHL tendoscopy can be used to release the split tendon to complete the FHL harvest.
拇长屈肌腱（FHL）转移术适用于跟腱缺损大于5 cm的重建。可通过微创技术在2区或3区获取该肌腱，其优点是软组织剥离最少。可通过2区FHL肌腱镜在载距突下方获取肌腱。将FHL转移至跟骨后结节是足够的。如果需要对跟腱巨大缺损进行双层重建，可通过肌腱剥离器在拇趾水平获取肌腱。然而，亨利主结的连接肌腱可与FHL或趾长屈肌腱一起劈开，而不是切断。可使用2区FHL肌腱镜松解劈开的肌腱以完成FHL的获取。
