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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

Ryosuke Sato
1   Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Naohito Hibino
1   Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Masahiro Yamano
2   Department of Plastic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Shinji Yoshioka
1   Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Tomoya Terai
1   Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Kenichiro Kita
1   Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Shingo Hama
1   Department of Orthopaedic Surgery, Tokushima Prefecture Naruto Hospital, Tokushima, Japan
,
Yoshitaka Hamada
3   Department of Orthopaedic Surgery, Kitasuma Hospital, Hyogo, Japan
,
Ichiro Tonogai
4   Department of Orthopaedic Surgery, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
,
Koichi Sairyo
4   Department of Orthopaedic Surgery, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
› Author Affiliations Funding None.
Further Information

Publication History

Received: 20 October 2017

Accepted: 18 December 2017

Publication Date:
20 March 2018 (online)

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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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