J Reconstr Microsurg 2014; 30(08): 569-580
DOI: 10.1055/s-0033-1358787
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Open Achilles Tendon Defects: A 12-year Study on the Injury Mechanisms, Reconstructions, and Late Complications

Yue-Liang Zhu
1   Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan Province, China
,
Yong-Qing Xu
1   Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan Province, China
,
Liang-Bin Mei
1   Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan Province, China
,
Yi Wang
1   Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan Province, China
,
Fu-Bing Li
1   Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan Province, China
,
Lin-Hui Sun
1   Department of Orthopaedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan Province, China
› Author Affiliations
Further Information

Publication History

24 June 2013

07 September 2013

Publication Date:
15 July 2014 (online)

Abstract

Background Open injuries of the Achilles tendon, which can be complicated by skin and bone injuries, continue to be a great challenge for surgeons. This study aims to report our experience with treatment of open Achilles tendon defects, focusing on the injury mechanisms, soft tissue coverage and late complications.

Methods A retrospective review was performed on 31 patients with open Achilles tendon defects between 1999 and 2011. The analyzed factors were injury mechanisms, surgeries, and long follow-up complications. The defect lengths of the Achilles tendons in the study ranged from 1 to 11 cm and the soft tissue defects ranged from 3 × 3 to 12 × 10 cm. Nine types of flaps were used for the coverage of concomitant skin defects.

Results Motorcycle spoke injuries were the most common cause of injury. There was no complete flap loss or rerupture of the reconstructed Achilles tendon. At the latest follow-up, all limbs were preserved and all the patients had regained full walking abilities. The algorithm of one-stage reconstruction was established, according to the defect length of the Achilles tendon and the defect size of skin. Late complications included maximum dorsiflexion loss and failure of heel raising ability on the single reconstructed foot.

Conclusion Open Achilles tendon defects are characteristic of concurrent skin and bone injuries and the reconstruction protocols of the different tissues should not be separated.