Reconstruction of Soft Tissue Defects Including the Achilles Tendon with Free Neurovascular Tensor Fascia Lata Flap and Fascia Lata: Case Report

Lidman, Disa; Nettelblad, Hans; Berggren, Anders; Rajan, Soma

doi:10.3109/02844318709078102

Cited by 45 publications

(26 citation statements)

References 4 publications

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“…The tensor fascia lata perforator (TFLP) flap 31,32 is occasionally used when there are anatomical variations of the ALT flap. If perforators to the anterolateral thigh region are not found or are found to be inadequate, then exploration proceeds in a lateral direction more proximally in the thigh.…”

Section: Tensor Fascia Lata Perforator Flapmentioning

confidence: 99%

Reconstruction of the hand and upper limb with free flaps based on musculocutaneous perforators

et al. 2004

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Since the advent of perforator flaps, a wide variety of applications have been documented. This study focuses on free flaps based on musculocutaneous perforators, because they have not been well-described in the literature of upper-limb reconstruction. They can be trimmed to be thin and pliable, and may provide large flaps with multiple components on the same pedicle to facilitate three-dimensional inset of flaps. Microvascular free flaps based on musculocutaneous perforators were performed in 36 cases for reconstruction of the thumb and thenar web, palm, dorsum of the hand, wrist, and forearm. They included the anterolateral thigh perforator flap (27 cases), thoracodorsal perforator flap (5 cases), and deep inferior epigastric perforator flap (4 cases). In 2 other cases not included in this series, the thoracodorsal perforator flap could not be elevated due to anatomical variations. There was no failure in this series, but complications included: 1) hematoma in 2 cases, and 2) infection in 2 cases with flap rim necrosis which was treated by a local rotation flap and skin graft. The thin flaps facilitated secondary reconstructive procedures, and only minor effort was required for the debulking procedure of the flaps. On average, these patients required 2.3 occasions of secondary procedures for further reconstruction following coverage with a perforator flap. The perforator flaps provide medium-thickness flaps for coverage of large defects in the upper limb with improved aesthetics and function. With careful dissection of the musculocutaneous perforators and primary thinning of the flaps, the use of a perforator flap is quite safe. Preservation of the muscles leads to better preservation of donor-site functions. Less requirement of secondary debulking procedures is a great advantage. However, caution should be taken in the presence of wound infection.

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Section: Tensor Fascia Lata Perforator Flapmentioning

confidence: 99%

Reconstruction of the hand and upper limb with free flaps based on musculocutaneous perforators

et al. 2004

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“…Achilles tendon reconstruction with TFL has been shown to result in a return to function with minimal difficulty with ambulation 24 months postoperatively. Only mild loss in the plantar flexion and dorsiflexion strength of the ankle and plantar flexion of the knee compared with the contralateral limb has been reported (32)(33)(34)(35)(36)(37)(38)(39). Both gross and histologic examinations performed at 30 months postoperatively have shown incorporation of the TFL autograft to the extent that it resembles normal Achilles tendon structure (36,39).…”

Section: Discussionmentioning

confidence: 89%

“…The use of a TFL autograft has most commonly been reported for reconstruction of Achilles tendon deficits (32)(33)(34)(35)(36)(37)(38)(39). Given the amount of TFL that can be harvested, it has been found to be an optimal graft for use when a large width or length is required for reconstruction (40,41).…”

Section: Discussionmentioning

confidence: 98%

Peroneal Tendon Reconstruction and Coverage for Treatment of Septic Peroneal Tenosynovitis: A Devastating Complication of Lateral Ankle Ligament Reconstruction With a Tendon Allograft

Schade¹,

Harsha

Rodman³

et al. 2016

The Journal of Foot and Ankle Surgery

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“…1,3,5,6 With advances in microsurgical techniques and refinements, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area without causing further damage to the traumatized leg. 2,4,[7][8][9][10][11][12][13][14][15] We report a single-stage reconstruction of the Achilles tendon region with a composite sensate free flap of dorsalis pedis and tendon strips of the extensor digitorum longus, which may be advantageous in situations involving a large Achilles tendon defect.…”

mentioning

confidence: 99%

Single-Stage Achilles Tendon Reconstruction Using a Composite Sensate Free Flap of Dorsalis Pedis and Tendon Strips of the Extensor Digitorum Longus in a Complex Wound

Kim

Hong²,

Lee³

et al. 2003

Annals of Plastic Surgery

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The reconstruction of the posterior heel including a wide defect of the Achilles tendon is difficult as a result of complicated infection, deficient soft tissue for coverage, and functional aspects and defects of the tendon itself. As a single-stage procedure, various methods of tendon transfer and tendon graft have been reported along with details of local flaps or island flaps for coverage. With advances in microsurgical techniques and subsequent refinements, several free composite flaps, including tendon, fascia, or nerve, have been used to reconstruct large defects in this area without further damaging the traumatized leg. The authors report such a single-stage reconstruction of a composite Achilles tendon defect using the extensor digitorum longus tendon of the second to fourth toe in combination with a dorsalis pedis flap innervated by the superficial peroneal nerve. The follow-up of this case has proved a satisfactory outcome to date.

show abstract

Reconstruction of Soft Tissue Defects Including the Achilles Tendon with Free Neurovascular Tensor Fascia Lata Flap and Fascia Lata: Case Report

Cited by 45 publications

References 4 publications

Reconstruction of the hand and upper limb with free flaps based on musculocutaneous perforators

Reconstruction of the hand and upper limb with free flaps based on musculocutaneous perforators

Peroneal Tendon Reconstruction and Coverage for Treatment of Septic Peroneal Tenosynovitis: A Devastating Complication of Lateral Ankle Ligament Reconstruction With a Tendon Allograft

Single-Stage Achilles Tendon Reconstruction Using a Composite Sensate Free Flap of Dorsalis Pedis and Tendon Strips of the Extensor Digitorum Longus in a Complex Wound

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