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Background: Chronic tears of the Achilles tendon can result in substantial loss of function, and are often challenging to repair because of muscle and tendon atrophy, retraction and short distal stump. Methods: Over 24 months follow up, 11 patients with chronic Achilles tendon rupture with a gap length more the 6 cm were treated by V-Y advancement Myotendinous flab augmented with peroneus brevis tendon transfer. Results: No patient showed re-rupture in the follow up period, the median time for partial weight bearing was 6.7 weeks (ranging from 6-9 weeks). While the median time for full weight bearing was 11.09 weeks (ranging from 10 to 15 weeks).The American Orthopedic Foot and Ankle society (AOFAS) score increased from 53.18 to 90.27, while the the Achilles Tendon Total Rupture Score (ATRS) improved from 26.27 to 84.9. While the pre-injury Tegner activity level score was 4.9 (ranging from 3-6) decreased to 4.6 (ranging from 3-6) 2 years post-operatively. Conclusions: V-Y Myotendinous advancement augmented with peroneusbrevis transfer is an effective method for management of chronic Achilles tendon rupture with gap length more than 6 cm.

V-Y Myotendinous advancement augmented with peroneus brevis transfer for management of chronic massive Achilles tendon rupture