Reconstruction of Combined Defects of the Achilles Tendon and the Overlying Soft Tissue With a Fascia Lata Graft and a Free Fasciocutaneous Lateral Arm Flap

Abstract

A new approach to reconstruction of the Achilles tendon and overlying soft tissue is presented. A fascia lata graft is used to reconstruct the tendon and is enwrapped by the fascia that is included in a fasciocutaneous lateral arm flap. Five patients were treated with this technique; three of them after surgical Achilles tendon repair, rerupture, and consecutive infection, one after a full-thickness burn with loss of the tendon and one with a history of ochronosis and necrosis of the whole tendon and overlying soft tissue. There were no anastomotic complications and all flaps healed primarily. Functional evaluation with the Cybex II dynamometer was done at least 49 months after reconstruction. A good functional and cosmetic result was obtained in all patients and donor site morbidity was acceptable. These results are well within the results of other surgical treatment options reported in the literature.

Reconstructive potential of the lateral arm flap after tumor resection

“…A neurosensory fasciocutaneous lateral arm flap covers exposed structures, allowing free gliding and providing sensation to the recipient site. 29 When deep structures are involved, bone, tendon, and muscle often have to be reconstructed; this demands a versatile flap incorporating the required tissue to achieve a good result in a single-stage procedure. Skeletal reconstruction using the lateral arm flap is an excellent option, 11,13,30 whereby tendon from the triceps muscle provides a strong vascularized graft.…”

Aesthetically and functionally satisfying reconstruction of an Achilles tendon and overlying skin defect in a 15 year old girl: A case report

“…There have been many reconstructive procedures described in literature, from local flaps to free tissue transfer via microsurgical treatments [1][2][3][4][5][6][7][8]. Some surgical techniques provide excellent healing outcomes in this complex reconstructive region, but if you keep the thickness of the transferred subcutaneous tissue in mind the aesthetic outcome is not always satisfying.…”

A new surgical method to treat chronic ruptures and reruptures of the Achilles tendon

“…In addition to primary repair, bridging techniques and/or augmentation with aponeurosis flaps, tendon transfers or synthetic grafts have been described [1,2,4,8,10,19,22,25,33].…”