Reconstruction of the Achilles tendon in the face of skin deficiency is a difficult surgical dilemma. Acute rupture with extensive local soft tissue trauma, as well as chronic rupture with or without associated infection, requires a more sophisticated reconstruction.
The reconstructive algorithm for an Achilles tendon rupture is well documented in the literature. Small segmental tendon defects, less than 2 cm without soft tissue trauma, can usually be primarily repaired with good success.1 Larger tendon defects have been successfully reconstructed with V-Y tendon flaps, gastrocnemius turn-down flaps, fascia lata grafts, Marlex mesh, and flexor hallucis longus interposition grafts.1, 2, 3, 4, 5All of these repairs rely on the presence of an adequate soft tissue envelope to allow wound closure, which is critical for proper tendon excursion, protection of the tendon from desiccation, and durability during ambulation. In the face of significant soft tissue loss associated with an...
KeywordsAchilles Tendon Posterior Tibial Artery Free Tissue Transfer Fasciocutaneous Flap Achilles Tendon Rupture
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