Reconstruction of Soft Tissue Defects Overlying the Achilles Tendon Using the Super Extended Abductor Hallucis Muscle Flap

Abstract

The super extended abductor hallucis muscle flap might represent an alternative to established methods because of ease of handling and a shorter anesthesia compared with a free flap procedure.

Multilayer reconstructions for defects overlying the Achilles tendon with the lateral‐arm flap: Long‐term follow‐up of 16 cases

“…Although smaller defects overlying the Achilles tendon can be closed with local skin flaps, larger defects require a local pedicled or free flap reconstruction. Local pedicled flaps that have been reported for this use are propeller flaps,23 the super extended abductor hallucis muscle flap,3 the distal soleus adiposal pull‐through composite flap,5 and the reverse flow sural flap 14, 23. The advantage these flaps offer is that no vascular anastomosis need to be made 3.…”

“…Local pedicled flaps that have been reported for this use are propeller flaps,23 the super extended abductor hallucis muscle flap,3 the distal soleus adiposal pull‐through composite flap,5 and the reverse flow sural flap 14, 23. The advantage these flaps offer is that no vascular anastomosis need to be made 3. Disadvantages are that these flaps are harvested near an infected site, and that muscle and fascia flaps without a skin component have to be covered with a skin graft,3, 4 which is of less quality than normal skin.…”

“…The advantage these flaps offer is that no vascular anastomosis need to be made 3. Disadvantages are that these flaps are harvested near an infected site, and that muscle and fascia flaps without a skin component have to be covered with a skin graft,3, 4 which is of less quality than normal skin. Several types of free flaps are reported for covering defects overlying the Achilles tendon, such as the anterolateral thigh,7, 9, 10 tensor fasciae latae,7 and infragluteal8 flap.…”

“…Reconstruction of this site is challenging; the local infection has to be controlled, stable multilayer coverage (skin, subcutaneous tissue, and fascia) has to be provided and in cases where the tendon has been severely damaged this has to be reconstructed as well. Techniques reported to date are axial patterned flaps for smaller defects,1, 2 and local3–5 and free6–10 flaps for larger defects.…”

Abductor hallucis muscle flap with circular external fixation for Charcot foot osteomyelitis: a case report

“…It is a Type II muscle defined as being supplied by one major proximal pedicle and minor distal pedicles. Successful coverage of wounds at the calcaneus, medial malleolus, and medial midfoot has been reported using the abductor hallucis muscle (4–7). The flap is advantageous since donor site morbidity is minimal and harvest does not harm the weight-bearing area; additionally, the majority of the donor site can be closed primarily while the muscle is easily covered with a split-thickness skin graft.…”