Surgical Treatment of Neglected Achilles Tendon Rupture .

Purpose: To evaluate the clinical and radiological outcomes of different surgical options for treatment of neglected Achilles tendon rupture like direct repair using V-Y lengthening and flexor hallucis longus (FHL) tendon transfer Method • This prospective study was conducted on twenty patients with neglected tendon Achilles rupture presented to the Orthopaedic Outpatient Clinic at Minia University Hospital in the period from June 2024 to June 2025 • Patients were divided into two groups, each group included 10 patients diagnosed clinically and by imaging studies as having neglected Achilles tendon rupture of more than 3 months duration since injury. The 1st group was operated by flexor hallucis tendon transfer and the 2nd group was managed by direct repair using V-Y lenghthening.Demographic data, comorbidities, surgical complications, and follow-up period were documented. Functional outcome was assessed using AOFAS and VAS. Results In the 1st group, the mean preoperative AOFAS score was 58.7 ± 4.35 (range 53–66), Following FHL transfer, the postoperative mean AOFAS score significantly improved to 90.2 ± 6.14 (range 80–100), The difference between pre- and postoperative values was highly significant (p < 0.001), confirming a marked enhancement in ankle and foot function after surgery. The mean preoperative VAS score was 6.00 ± 0.67 (range 5–7). After FHL transfer, the mean postoperative VAS score markedly decreased to 1.50 ± 0.71 (range 0–2),. This difference was highly significant (p < 0.001).