J Reconstr Microsurg 1993; 9(5): 321-325
DOI: 10.1055/s-2007-1006737

© 1993 by Thieme Medical Publishers, Inc.

Management of Chronic Achilles Tendon Infection with Musculotendinous Gracius Interposition Free-Flap Coverage

Robert J. Feibel, Rebecca L. Jackson, William C. Lineaweaver, Harry J. Buncke
  • Department of Surgery, Division of Orthopaedic Surgery, University of Ottawa; Microsurgical Transplantation-Replantation Division, Davies Medical Center, UCSF; and Divisions of Hand Surgery and Plastic and Reconstructive Surgery, Stanford University School of Medicine
Further Information

Publication History

Accepted for publication 1993

Publication Date:
08 March 2008 (online)


Management of infected Achilles tendon repair poses a significant reconstructive problem. Thorough debridement is most important and resection of non-viable tendon substance is required. Reconstruction of such tendon defects requires vascularized soft-tissue coverage that is stable and that offers the possibility of functional restoration. Gracilis free-tissue transfer is an effective means of providing stable, durable, well-vascularized, soft-tissue coverage in an infected Achilles tendon repair. The microsurgical anastomoses are technically straightforward. Cybex II dynomometer measurements, performed 6 months following free-tissue transplantation, revealed strength (torque) and power, at an angular velocity of 45 degrees per second, of: 59 percent and 52 percent, respectively, compared to the uninjured side. Endurance was assessed at an angular velocity of 120 degrees per second over a 15-second test interval, and was noted to be 81 percent, compared to the normal ankle. Excellent functional results and acceptable soft-tissue contour can be expected with this technique.