Single-stage reconstruction of Achilles tendon injuries and distal lower extremity soft tissue defects with the reverse sural fasciocutaneous flap

Management of Open Chronic Tendo Achilles Injuries: A case report

“…2,3 This flap is based on the distribution of the sural nerve and the retrograde perfusion is maintained by the anastomoses of the cutaneous perforating branches of the peroneal artery and the median superficial sural artery. 2,3 This flap remains the workhorse for soft tissue cover over the posterior distal third of the leg and heel. 2,3 It is a relatively simple flap that can be performed by most orthopaedic surgeons.…”

“…2,3 This flap remains the workhorse for soft tissue cover over the posterior distal third of the leg and heel. 2,3 It is a relatively simple flap that can be performed by most orthopaedic surgeons. 2,4 The Tendo Achilles slide can be done through the same incision used for elevation of the flap.…”

“…2,3 It is a relatively simple flap that can be performed by most orthopaedic surgeons. 2,4 The Tendo Achilles slide can be done through the same incision used for elevation of the flap. The resultant flap is however, often quite bulky.…”

“…These include lengthening the aponeurotic tendon either in a 'tongue in groove' fashion as described by Baker, or the V-Y technique popularized by Abraham and Pankovich. 1,2 The other methods described for repair of neglected rupture include augmentation with the peronei (Teuffer's modification of White and Kraynick technique), or with a strip from the median raphe of the proximal tendon (Bosworth's technique).…”

“…The use of vascularised extensor digitorum brevis and various composite free flaps have been described for such defects. 2 These require the expertise of a micro vascular surgeon. We present the case of a patient who presented with a 4 x 5 cm open wound and a 4 cm segmental loss of the tendon six months following a fall.…”