FHL Tendon Transfer

Patients suffering from a diseased Achilles tendon may benefit from FHL (flexor hallucis longus) tendon transfer to stabilize and increase the function of an injured Achilles tendon.

What You Need To Know About FHL Tendon Transfer

What is an FHL Tendon Transfer?

An FHL transfer repositions the flexor hallucis longus tendon, (commonly called the "FHL" tendon) to reinforce a diseased Achilles tendon. The FHL tendon travels along the inner side of the ankle and foot. This tendon is responsible for flexing the big toe. Repositioning it adds strength to the Achilles.

An FHL tendon Transfer can help people with a weakened Achilles tendon. An Achilles tendon transfer surgery reconstructs the foot, moving the tendon from its regular location to an area that facilitates more natural function and comfort. Once repositioned, the ankle and foot revert to less restrained movement.

Finding the best relief for your Achilles pain starts with a visit to Resurgens Orthopaedics. We have many Foot & Ankle centers to serve you. Schedule an appointment today!

Why is FHL Tendon Transfer Performed?

Any strain on the Achilles tendon that causes discomfort or limited motion in the ankle or foot may require an FHL tendon transfer. The procedure supports the overused and overstretched Achilles.

Patients undergo FHL tendon transfer when suffering from tendonitis or an Achilles tendon injury. Their overused or overstretched Achilles tendon needs the support of the FHL tendon to aid the ankle and foot in more stable movements. The procedure is also standard in patients with Haglund's deformity (bone spurs) or any disorder in the foot that may require strength from the FHL tendon to increase mobility.

What Happens During FHL Tendon Transfer?

Preparation: During an FHL Tendon Transfer, the patient is put to sleep with anesthesia. One of our expert surgeons makes an incision, exposing your Achilles tendon and the heel bone (calcaneus). The surgeon removes any bony bumps on the calcaneus or diseased tissue from the Achilles.

Detaching the tendon: The Surgeon finds the FHL tendon (either through the current incision or an additional incision), exposes and cuts the tendon, and disconnects it from your big toe.

Shifting the tendon: Then, the surgeon relocates your FHL by drilling a small tunnel in your calcaneus. The tunnel, located next to your Achilles tendon, positions the FHL to aid the ankle and foot in mobility. Once relocated, the FHL is trimmed and reinforced with an anchor that holds it in place.

End of the Procedure and After Care: After your FHL Achilles tendon surgery, the surgeon closes your incision and provides a cast or boot to support your healing foot. Our staff monitors your recovery briefly before you return home.

Are There Risks Associated With FHL Tendon Transfer?

An FHL Tendon Transfer is a relatively safe procedure. However, every surgery carries its inherent risks.

You may experience these conditions after receiving an FHL transfer:

A weak big toe: After surgery, some patients notice a loss of strength in their big toe. After a time, the foot adjusts to the new positioning of the FHL, and movement feels more regulated.

Wound not healing: If your wound does not seem to be healing correctly, call Resurgens Orthopaedics immediately. Unhealed wounds can lead to infection and spread quickly into other parts of the foot.

Infection: Infection more commonly occurs in the Achilles tendon because the Achilles tendon is covered by less skin than other areas in the body. An infected wound can often require more surgery.

Unanchored FHL Tendons: Occasionally, the anchor holding the FHL in place detaches from the calcaneus. The detachment typically occurs just weeks after surgery.

Post FHL Tendon Transfer & Recovery

While recovery times for an Achilles repair with FHL transfer differ slightly, most patients will:

  • Require brief monitoring right after their surgery

  • Wear a cast or boot for several weeks

  • Avoid placing weight on foot for several weeks

  • Require physical therapy as the foot heals

  • Lose some strength in their big toe

  • Notice improvement in 10-12 weeks

  • Feel optimally improved in 15-18 months

At Resurgens Orthopaedics, Our patients come to us with bone pain, stiffness, tears, and limited motion. We assist them on their healing journey, restoring movement and comfort to their body.

If you are suffering from pain in your Achilles tendon or experiencing other orthopaedic issues, schedule an appointment today.

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