Abstract
Segmental loss of the Achilles tendon with overlying soft tissue and skin defect remains
a complex reconstructive challenge. Successful reconstruction combines tendon repair
with coverage of the defect by soft tissue flaps, creating an entity that meets up
to three predetermined goals: (1) approaching preinjury functionality, (2) resisting
shearing forces, and (3) achieving an esthetic result. From June 2009 to June 2011,
our center submitted six patients to a one-stage procedure correcting the Achilles
tendon using a composite free anterolateral thigh (ALT) flap with vascularized fascia
lata. The flap sizes ranged from 5 to 8 cm in width and 16 to 20 cm in length and
all flaps included vascularized fascia lata which was rolled to serve as an Achilles
tendon. After reconstruction our patients showed good functional results, these patients
could walk, climb stairs, and tiptoe again without support. Moreover, normal footwear
could be worn. A free composite ALT flap with vascularized fascia lata is a reliable
option for coverage of Achilles tendon and overlying soft tissue defects, even in
elderly patients.
Keywords
soft tissue defect - Achilles tendon - reconstruction - anterolateral thigh (ALT)
flap - fascia lata
