Achilles tendon reconstruction with a half-width Achilles graft and wrap-around fascial flap
- Author:
Theddeus Octavianus Hari PRASETYONO
1
;
Fransisca SISCA
Author Information
- Publication Type:Case Report
- Keywords: Achilles tendon; Gait; Reconstructive surgical procedures; Tourniquets
- MeSH: Achilles Tendon; Aged; Anesthesia, General; Ankle; Follow-Up Studies; Gait; Humans; Magnetic Resonance Imaging; Reconstructive Surgical Procedures; Rupture; Sutures; Tendons; Tourniquets; Transplants; Walking
- From:Archives of Plastic Surgery 2019;46(3):267-271
- CountryRepublic of Korea
- Language:English
- Abstract: A 70-year-old man complained imbalance while walking, inability to perform ankle flexion, and could not stand on tip-toe 3 months after injury. The ankle looked swollen with loss of Achilles contour and obvious gait disturbance. Magnetic resonance imaging shows a 5-cm Achilles tendon gap. Subsequently, surgery was performed to solve the neglected Achilles tendon rupture. Patient was put under general anesthesia with a regional block. Using a non-tourniquet technique, a reconstructive procedure was performed using a half-width autologous Achilles tendon graft, which was attached to the calcaneal prominence with wire in a double strand Bunnell fashion. As for the proximal stump, double core Bunnell/modified Kessler suturing was carried out to suture the graft to Achilles stump. To increase the vascularization, an ipsilateral gastrocnemius fascial flap with a distally based-pedicle was harvested to wrap around the tendon graft. At a 6-month follow-up, the patient was able to stand on tip-toe and had also regained a normal gait.
