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Reconstruction of Segmental Defects of Achilles Tendon: Is It a Must in Infected Complex Defects?

Overview
Journal Indian J Plast Surg
Publisher Thieme
Specialty General Surgery
Date 2013 Aug 21
PMID 23960317
Citations 3
Authors
S Raja Sabapathy
Hari Venkataramani
Latheesh Latheef
Praveen Bhardwaj
Affiliations
Soon will be listed here.
Abstract

Loss of Achilles tendon combined with overlying soft tissue loss is a challenging problem. Multiple techniques like tendon graft with coverage by soft tissue flap or composite flaps have been used. All these options are technically demanding. Reports do exist whereby muscle flaps bridging the defect used as cover in course of time could transmit the tendon force across the defect. We are presenting a case where a free gracilis muscle flap used to cover the soft tissue defect at the Achilles tendon at 2 years follow up provided stable cover and produced active function of the Achilles tendon allowing the patient to stand tip toe. Mechanism of its action has been analysed by MRI and M-mode ultrasound. While in primary Achilles tendon injury reconstruction is still the recommended option, in complex situations mere filling of the gap with the flap without formal reconstruction of the tendon could give good functional outcome. This technique can be used in demanding situations.

Citing Articles

"Repair and Flap technique": A Retrospective Analysis of Single Stage Reconstruction Method for Treatment of Chronic Open Achilles Tendon Defect with Proximal Turndown Flap and Reverse Sural Flap.

Nambi G, Salunke A, Pathak S, Sahijwani H, Menon P, Chaudhari M Indian J Orthop. 2021; 55(Suppl 1):149-156.

PMID: 34122768 PMC: 8149510. DOI: 10.1007/s43465-020-00278-1.

Non-microsurgical bipedicled reverse sural fasciocutaneous flap with preservation of medial and lateral sural cutaneous nerve: Current surgical management of skin defect after traumatic Achilles tendon rupture - A case report.

Novriansyah R, Prabowo I, Laras S Int J Surg Case Rep. 2020; 78:259-264.

PMID: 33373919 PMC: 7776118. DOI: 10.1016/j.ijscr.2020.12.027.

Management of Chronic Achilles Tendon Injuries-Review of Current Protocols and Surgical Options.

Periasamy M, Venkatramani H, Shanmuganathan R Indian J Plast Surg. 2019; 52(1):109-116.

PMID: 31456619 PMC: 6664832. DOI: 10.1055/s-0039-1687923.

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