One-Stage Reconstruction for Re-rupture of Achilles Tendon with Soft Tissue Infection: Using an Anterolateral Thigh Flap Incorporating a Vascularized Muscle Flap and a Strip of Iliotibial Tract

Ryosuke Sato; Naohito Hibino; Masahiro Yamano; Shinji Yoshioka; Tomoya Terai; Kenichiro Kita; Shingo Hama; Yoshitaka Hamada; Ichiro Tonogai; Koichi Sairyo

doi:10.1055/s-0038-1630141

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2018; 10(02): 105-108
DOI: 10.1055/s-0038-1630141

Case Report

Thieme Medical and Scientific Publishers Private Ltd.

One-Stage Reconstruction for Re-rupture of Achilles Tendon with Soft Tissue Infection: Using an Anterolateral Thigh Flap Incorporating a Vascularized Muscle Flap and a Strip of Iliotibial Tract

Authors

Ryosuke Sato

¹Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Naohito Hibino

¹Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Masahiro Yamano

²Department of Plastic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Shinji Yoshioka

¹Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Tomoya Terai

¹Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Kenichiro Kita

¹Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Shingo Hama

¹Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
Yoshitaka Hamada

³Department of Orthopaedic Surgery, Kitasuma Hospital, Hyogo, Japan
Ichiro Tonogai

⁴Department of Orthopaedic Surgery, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
Koichi Sairyo

⁴Department of Orthopaedic Surgery, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan

Abstract

Reconstruction is challenging in a patient with loss of a segment of Achilles tendon and infection in the overlying soft tissue. Here the authors describe one-stage tendon reconstruction, using an anterolateral thigh free flap incorporating a vascularized muscle flap and a strip of iliotibial tract in a patient with re-rupture of an Achilles tendon and soft tissue infection. Postoperative immobilization of the affected ankle using an external fixator enabled us to observe the flap directly and reduce pressure on the flap. The patient had a successful outcome, with no difficulty in walking, running, or climbing stairs and no limitation of range of motion at the ankle joint postoperatively. This is a promising technique for reconstruction of the Achilles tendon and treatment of infection as a one-step procedure.

Keywords

Achilles tendon - anterolateral thigh flap - one-stage reconstruction - re-rupture

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References

References
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